Logan Marie Ketchum, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301010763 Issued in MI

Practice address

24285 Red Arrow Hwy Ste a
Mattawan, MI 49071-7700

Phone

(269) 399-4690

NPI assigned

Jan 17, 2019

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

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Midwest Chiropractic and Rehab LLC

  • Chiropractor
  • Mattawan, MI
  • NPI 1457008559
  Medicare reassignment NPD Authorized official
• Kinetic Health Chiropractic

  • Chiropractor
  • Mattawan, MI
  • NPI 1801502141
  NPD (past)

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1639643117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24285 RED ARROW HWY STE A",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490717700",
            "telephone_number": "269-399-4690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24285 RED ARROW HWY STE A",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490717700",
            "telephone_number": "269-399-4690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8175 Creekside Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "490245370",
            "country_code": "US",
            "telephone_number": "269-324-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7901 S 12th St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "490243831",
            "country_code": "US",
            "telephone_number": "269-324-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETCHUM",
        "first_name": "LOGAN",
        "middle_name": "MARIE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-17",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald C Jacks, R.PH.
• Maureen Johnson
• Mahmoud Hassan Kassir, MD
• Stephanie Keeler
• Stephanie J Kendall, LMT
• Keynote Pediatric Speech and Language Therapy LLC
• Hibah Khan
• Mahum Khan
• Kinetic Health Chiropractic
• Amber Young Kirk, BCBA

• Chiropractor in Mattawan, MI
• Providers in Mattawan, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.