Amber Ketchum, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

9130 Brae GLN
San Antonio, TX 78249-3850

Phone

(210) 823-5443

NPI assigned

Dec 22, 2022

Last updated

Dec 22, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fuel for LifeGroup PAC ID 0143635680, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fuel for Life

  • Registered Dietitian
  • Cedar Park, TX
  • NPI 1629675483

  Dietitian, Registered

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1671667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1790497550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9130 BRAE GLN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782493850",
            "telephone_number": "210-823-5443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9130 BRAE GLN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782493850",
            "telephone_number": "210-823-5443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHUM",
        "first_name": "AMBER",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-22",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.homemadenutrition.com",
            "affiliation": "N",
            "endpointDescription": "professional website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9130 Brae Gln",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782493850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shantha Kesavulu, M.D.
• Brooke Kesecker
• Nikhaar Keshwani
• Deanna D Kesinger, RN
• Marc David Kessner, O.D.
• Vanaja Rani Kethireddy, M.D
• Elijah Ketron
• Shanna Camille Ketron, AU.D., CCC-A, FAAA
• Barrett Ketter
• William Albert Ketterer, DO

• Registered Dietitian in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.