Keneth Kibet Ngetich, CNP
Individual provider Active NPI Family Nurse Practitioner · Lithopolis, OH
NPI 1881472363 · NPPES record last updated Mar 26, 2025
Key facts
- NPI
- 1881472363
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 0033764 (OH)
- Practice address
- 205 Poe Ave
Lithopolis, OH 43136-9777 - Phone
- (301) 825-2795
- NPI assigned
- Sep 18, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250522001703 | OH | Practitioner - Nurse Practitioner | 2567981566 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0033764 | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohiocare Inc. | Current |
Accepting new patients | |
| Gateway Medical Center LLC | Current |
Accepting new patients |
Locations
4200 Regent St
Ste 200
Columbus, OH 43219
Phone (877) 581-2210
3433 Agler Rd
Ste 1100
Columbus, OH 43219
Phone (614) 453-1065
7652 Sawmill Rd
Dublin, OH 43016
Phone (614) 390-2764
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0033764 | OH | Yes |
Addresses
Primary practice location
205 Poe Ave
Lithopolis, OH 43136-9777
Mailing address
205 Poe Ave
Lithopolis, OH 43136-9777
Phone (301) 825-2795
Other providers in Lithopolis, OH
- Chelsea Lanning
- Shanetta Love
- Makarios Autism Center
- Ashley Mills
- Mysanndy Transportation LLC
- Vivienne T Nkengafac
- Perry Therapy Center LLC
- Heather Pontius
- Emily Lynn Randall
- Renewed Serenity, LLC
All providers in Lithopolis, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 26, 2025. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.