Individual provider Active NPI

Leah Ketchum, NP

  • Family Nurse Practitioner
  • Morton, MS
National Provider Identifier
1780141044
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
903189 Issued in MS
Practice address
317 Highway 13 S
Morton, MS 39117-3353
Phone
(601) 732-6301
NPI assigned
Feb 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 903189 MS Primary
Nurse Practitioner 363L00000X 903189 MS

Addresses

Primary practice location

317 Highway 13 S
Morton, MS 39117-3353

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698

Other practice location 1

823 Grand Ave
Yazoo City, MS 39194-3233
Phone (662) 746-2261

Other names 1

  • Leah Harper Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20190510001451 MS Practitioner - Nurse Practitioner 3072856236 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
903189MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Mississippi, PLLC Nurse Practitioner CurrentSince Jul 1, 2020 Accepting new patients
Monogram Health Professional Services PC Nurse Practitioner CurrentSince Dec 19, 2024 Accepting new patients
Monogram Health Professional Services PC Nurse Practitioner CurrentSince Dec 19, 2024 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince Jul 1, 2020 Accepting new patients
Yazoo Emergency Group, LLC Nurse Practitioner CurrentSince Nov 17, 2019 Accepting new patients
Rush Medical Foundation Past Accepting new patients

Locations

200 Corporate Blvd
Lafayette, LA 70508

1806 Simpson Highway 49
Magee, MS 39111
Phone (601) 439-1420

1000 Highland Colony Pkwy
Ste 5203
Ridgeland, MS 39157
Phone (601) 427-4734

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

823 Grand Ave
Yazoo City, MS 39194
Phone (601) 746-2261

Interoperability endpoints

  • Direct secure messaging: leah.ketchum.1@22854.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1780141044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 HIGHWAY 13 S",
            "city": "MORTON",
            "state": "MS",
            "postal_code": "391173353",
            "telephone_number": "601-732-6301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "823 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Yazoo City",
            "state": "MS",
            "postal_code": "391943233",
            "country_code": "US",
            "telephone_number": "662-746-2261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETCHUM",
        "first_name": "LEAH",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-22",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903189",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "903189",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEAH",
            "last_name": "HARPER",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Morton, MS

Sources for this page

Verify at the official NPI Registry.