Derek Kenneth Ketchum, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC-05036 Issued in OH

Practice address

504 E Business Way
Sharonville, OH 45241-2374

Phone

(513) 354-3800

NPI assigned

Dec 31, 2020

Sex

Male

Sole proprietor

No

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

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 and National Provider Directory roles.

• Nicholas Rohlfs DC LLC

  • Chiropractor
  • Cincinnati, OH
  • NPI 1881167740
  NPD
• Matthew R Syrek DC LLC

  • Sports Physician Chiropractor
  • Maumee, OH
  • NPI 1245535129
  NPD (past)

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

{
    "created_epoch": "1609372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1891383246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4369 COACH LIGHT TRL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454248042",
            "telephone_number": "419-513-9368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 E BUSINESS WAY",
            "city": "SHARONVILLE",
            "state": "OH",
            "postal_code": "452412374",
            "telephone_number": "513-354-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Elm St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "OH",
            "postal_code": "451772878",
            "country_code": "US",
            "telephone_number": "937-566-0171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETCHUM",
        "first_name": "DEREK",
        "middle_name": "KENNETH",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-31",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "DC-05036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Eileen Ivory, M.ED., BCBA
• Vada Jackson, LISW
• Cindy E Jimenez de Cabrera, CNP
• Hannah Kaminsky, LPC
• Kansagra Dentists of Sharonville PC, Inc
• Megan Kopack, MA, LPCC, LPC
• Michele Ann Lapsins, RPH
• Miranda Lazar, CNP
• Learning Appropriate Behaviors
• Joseph Lyons, MD

• Chiropractor in Sharonville, OH
• Providers in Sharonville, OH by specialty
• Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; 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.