JONATHAN F. KETCHUM (NPI# 1922195627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922195627 |
| Entity Type | Individual |
| Full Name | JONATHAN F. KETCHUM |
| Credential | D.P.M. |
| Practice Address |
488 Pleasant St Worcester MA 01609-1857 |
| Mailing Address |
126 Bushy Ln Rutland MA 01543-2025 |
| Practice Telephone | 5087559573 |
| Mailing Telephone | 5088866280 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2008-03-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
2087 | MA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | NEIGHBORHOOD HEALTH | 0019046 | 01 |
| MA | 0316644 | 05 | |
| MA | UNITED HEALTHCARE | 2700355 | 01 |
| MA | HARVARD PILGRIM HEALTH | 333402 | 01 |
| MA | TUFTS HEALTH PLAN | 002087 | 01 |
| MA | BLUE SHIELD OF MA | Y71045 | 01 |
| Street Address |
488 PLEASANT ST |
| City | WORCESTER |
| State | MA |
| Zip Code | 01609-1857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447208715 | Richard Alan Grossman | Optometrist | 488 Pleasant St, Worcester, MA 01609-1857 | 2006-05-05 |
| 1700268489 | Eyes On Worcester LLC | Optometrist | 488 Pleasant St, Worcester, MA 01609-1857 | 2015-06-18 |
| 1063815066 | Giolekas Sports and Family Chiropractic, Inc. | Chiropractor | 488 Pleasant St, Worcester, MA 01609-1857 | 2014-10-03 |
| 1851585244 | Optometry Associates of Worcester Inc. | Optometrist | 488 Pleasant St, Worcester, MA 01609-1857 | 2007-08-29 |
| 1821185455 | Medical Center West Podiatry Associates, Inc. | Podiatrist | 488 Pleasant St, Worcester, MA 01609-1857 | 2006-10-06 |
| 1811080161 | Angelo Giolekas | Chiropractor | 488 Pleasant St, Worcester, MA 01609-1857 | 2006-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669018388 | Alyssa Lynne Szymkowicz | Counselor | 2b Pelham Street, Apartment 3, Worcester, MA 01609 | 2019-11-19 |
| 1295200848 | Carmen P Rivera Martinez | Counselor | 20 Irving Street, Worcester, MA 01609 | 2018-10-10 |
| 1386126704 | Sarah J Macdonald | Psychologist | 27 Sever St, Worcester, MA 01609 | 2018-09-01 |
| 1437641107 | Christopher Quoc-duy Nguyen | Dentist | 111 Elm Street Suite 203, Worcester, MA 01609 | 2018-05-30 |
| 1396190096 | Dasa Home Health Inc | Home Health | 255 Park Ave Ste 1101a, Worcester, MA 01609 | 2016-04-30 |
| 1912306135 | Neighborhood Dental Group, PC | Dentist | 111 Elm St Suite 203, Worcester, MA 01609 | 2014-08-14 |
| 1306254875 | Brenda Mccarthy-trayah | Counselor | 198 Russell St., Worcester, MA 01609 | 2014-07-29 |
| 1386052009 | Allene Rizzolo | Early Intervention Provider Agency | 548 Park Ave., South Bay Early Intervention, Worcester, MA 01609 | 2014-07-25 |
| 1477849032 | Diversified Staffing | Nursing Care | 39 Salisbury Street, Worcester, MA 01609 | 2011-06-22 |
| 1508195140 | 64 Highland Dental | Dentist | 64 Highland Street, Worcester, MA 01609 | 2009-12-10 |
| Find all providers in zip 01609 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588879753 | Honor G Manilla | Podiatrist | 2060 Valley Forge Rd, Worcester, PA 19490-0070 | 2007-05-11 |
| 1487697116 | Honor G Manilla | Podiatrist | 2060 Valley Forge Road, Worcester, PA 19490-0070 | 2006-06-13 |
| 1821185455 | Medical Center West Podiatry Associates, Inc. | Podiatrist | 488 Pleasant St, Worcester, MA 01609-1857 | 2006-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912449133 | Ayleen Gregorian Dpm | Podiatrist | 22 Park Ln, Harvard, MA 01451-1436 | 2016-11-07 |
| 1851625438 | John M Santo | Podiatrist | 5 Dennett Dr, Newburyport, MA 01950-3303 | 2009-09-29 |
| 1285825364 | Dr Malcolm I Price | Podiatrist | 79 Prichard St, Fitchburg, MA 01420-3247 | 2007-08-05 |
| 1205042397 | Edward T Hurwitz Dpm PC | Podiatrist | 394 W Broadway, South Boston, MA 02127-2215 | 2007-05-15 |
| 1770647943 | Kenneth Michael Lavin | Podiatrist | 272 Chauncy Street Suite 4, Mansfield, MA 02048 | 2006-12-21 |
| 1225198906 | Robert W Uhrich | Podiatrist | 3 Bessom St, #249, Marblehead, MA 01945-2372 | 2006-12-11 |
| 1073690285 | David Crosier Whitney Sr. | Podiatrist | 95c Davis Straits, Falmouth, MA 02540-3909 | 2006-11-01 |
| 1467532812 | Daniel M. Rutowicz | Podiatrist | 145 Rosemary St Ste B, Needham, MA 02494-3259 | 2006-10-17 |
| 1790872497 | Anthony J Tickner | Podiatrist | 439 Main St, Hudson, MA 01749-1855 | 2006-10-06 |
| 1447343744 | Albert A Daly | Podiatrist | 253 Salem St, Malden, MA 02148-4118 | 2006-10-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.