Christopher Frederick Ketcham, DO
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · South Bend, IN
NPI 1780098780 · NPPES record last updated May 19, 2026
Key facts
- NPI
- 1780098780
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- 02005317A (IN)
- Practice address
- 100 Navarre PL Ste 4440
South Bend, IN 46601-1171 - Phone
- (574) 647-5300
- Fax
- (574) 647-5305
- NPI assigned
- Jun 17, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Physical Medicine and Rehabilitation
- Education
- University of Pikeville, Kentucky College of Osteopathic Med, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Beacon Medical Group Inc
Practice addresses (Care Compare)
100 Navarre PL
6600 BMG N Central Neurosurgery SB
South Bend, IN 46601-1173
Phone (574) 647-8800
Hospital & facility affiliations
- Elara Caring
- Memorial Hospital of South Bend
- Elkhart General Hospital
- Lakeland Hospital, St Joseph
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180710001002 | IN | Practitioner - Physical Medicine and Rehabilitation | 0941512362 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02005317A | IN | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Medical Group Inc | Current |
Accepting new patients | |
| Beacon Medical Group, Inc. | Current |
Accepting new patients | |
| Beacon Medical Group, Inc. | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Physical Medicine & Rehabilitation | Past |
Accepting new patients |
| Beacon Medical Group, Inc. | Past | Accepting new patients |
Locations
6913 N Main St
Granger, IN 46530
Phone (574) 647-1500
3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129
900 I St
Laporte, IN 46350
Phone (219) 324-1670
111 W Jefferson Blvd
Ste 100
South Bend, IN 46601
Phone (574) 647-1669
615 N Michigan St
Fl 1
South Bend, IN 46601
Phone (574) 647-1100
100 Navarre Pl
Ste 6600
South Bend, IN 46601
Phone (574) 232-7227
1815 E Ireland Rd
South Bend, IN 46614
Phone (574) 647-1700
100 Navarre Pl
Ste 4440
South Bend, IN 46601
Phone (574) 647-4540
710 N Niles Ave
South Bend, IN 46617
Phone (574) 647-1610
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 02005317A | IN | Yes |
Addresses
Primary practice location
100 Navarre PL Ste 4440
South Bend, IN 46601-1171
Mailing address
3245 Health Dr Ste 100
Granger, IN 46530-1380
Other practice location 1
3220 Beacon Pkwy Ste 220
Granger, IN 46530-7196
Phone (574) 999-8838
Other practice location 2
1815 E Ireland Rd
South Bend, IN 46614-2845
Phone (574) 647-1700
Other practice location 3
615 N Michigan St 1st Fl Hospitalist Ste
South Bend, IN 46601-1033
Phone (574) 647-3050
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300014121 | Medicaid | IN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cketcham@mybeacon.cernerdirect.com |
Other providers in South Bend, IN
- Nicholas Harold Kerr
- Kristen Anne Kertesz
- Alexa Rose Kessen
- Melissa N Kessie
- Ketamine Is Hope LLC
- Sedra Jo Ketcham
- Thomas R. Keucher
- Evelin Keultjes
- Walid Khabbaz
- Harmanjot Singh Khaira
All providers in South Bend, IN · Physical Medicine & Rehabilitation Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.