Zachary Ketcham

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306604533 Issued in VA

Practice address

14235 Woods Edge Rd
South Chesterfield, VA 23834-6019

Phone

(804) 400-0886

NPI assigned

Jul 29, 2016

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469750400000",
    "number": "1699228262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14235 WOODS EDGE RD",
            "city": "SOUTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "238346019",
            "telephone_number": "804-400-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14235 WOODS EDGE RD",
            "city": "SOUTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "238346019",
            "telephone_number": "804-400-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHAM",
        "first_name": "ZACHARY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-29",
        "last_updated": "2016-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306604533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jawed Iqbal, M.D
• Raquel E Jefferson
• JMT Consulting
• Khalia Ahqueen Johnson
• Jewell Kearney, NA
• Li Pan King
• Roy Knight, TRANSPORTATION
• Alfred Lee, M.D.
• Melissa Macminn, NP
• Ciara Macmullen, RBT

• All providers in South Chesterfield, VA
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.