Alicia Hagenau Ketchum, ARNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9278289 Issued in FL

Practice address

120 Medical Blvd
Ste 102
Spring Hill, FL 34609-0220

Phone

(352) 686-0086

Fax

(352) 684-2081

NPI assigned

Mar 14, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Integritynp, LLC

  • Gerontology Nurse Practitioner
  • Wesley Chapel, FL
  • NPI 1730636820
  Medicare reassignment NPD
• Total Care Plus LLC

  dba Total Care Plus

  • Urgent Care Clinic/Center
  • Brooksville, FL
  • NPI 1376069948
  Medicare reassignment NPD
• K Wade Foster MD PA

  dba Florida Dermatology & Skin Cancer Centers

  • MOHS-Micrographic Surgery Physician
  • Winter Haven, FL
  • NPI 1205066404
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1394755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1588080501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14690 SPRING HILL DR",
            "address_2": "STE 100 ATTN:CREDENTIALING",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346098102",
            "telephone_number": "352-799-0046",
            "fax_number": "352-606-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MEDICAL BLVD",
            "address_2": "STE 102",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346090220",
            "telephone_number": "352-686-0086",
            "fax_number": "352-684-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHUM",
        "first_name": "ALICIA",
        "middle_name": "HAGENAU",
        "credential": "ARNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-14",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9278289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016886300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alecia Kenney, BS
• Kernaghan and Moore: Speech and Language Therapy Services, Inc.
• Jennifer Kerouac
• Amanda Lynn Kerr
• Brian L. Kersey, P.A.
• Keti Medical Center & Pain Management Inc
• Kemisha L Key, M.D.
• Ahmed Hussain Khan, MD
• Amena Khan, NP
• Ariel Khy, RBT

• Family Nurse Practitioner in Spring Hill, FL
• Providers in Spring Hill, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.