MRS. ANNE MONTGOMERY KETCHAM (FNP-BC) – Family Nurse Practitioner, NPI 1093189276

MRS. ANNE MONTGOMERY KETCHAM (FNP-BC) is a healthcare provider. based in Homewood, Alabama. specializing in Family Nurse Practitioner. They hold the professional credentials FNP-BC. They hold a License No. 1-127785 (AL). The NPI Number for MRS. ANNE MONTGOMERY KETCHAM (FNP-BC) is 1093189276

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
MRS. ANNE MONTGOMERY KETCHAM (FNP-BC)
NPI
1093189276
Phone
(334) 462-2241
Address
504 BROOKWOOD BLVD
Enumeration Date
25 November 2015
Last Update Date
11 February 2016

Doctor Profile

Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Secondary Phone
2058719661
Graduation Year
2015 (11 years ago)
PAC ID
6709180565
Group Practice PAC ID
1254358310
Professional Enrollment ID
I20160215002595
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

Provider Addresses for MRS. ANNE MONTGOMERY KETCHAM (FNP-BC)

  • 504 BROOKWOOD BLVD

    HOMEWOOD, AL 352096802

    Phone: (334) 462-2241

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-02-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160215002595INurse PractitionerALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35209)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1254358310View full group profile
NameSpecialtyState
Nurse PractitionerAL
-AL
Nurse PractitionerAL
-AL
Allergy/Immunology, Internal Medicine, Pediatric MedicineAL
Nurse PractitionerAL
-AL
Allergy/Immunology, Internal MedicineAL
-AL
Nurse PractitionerAL

Reviews

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Frequently asked questions

What is the registry number for MRS. ANNE MONTGOMERY KETCHAM (FNP-BC)?
The registry entry for MRS. ANNE MONTGOMERY KETCHAM (FNP-BC) shows NPI 1093189276.
Is MRS. ANNE MONTGOMERY KETCHAM (FNP-BC)'s NPI status active today?
Active status means MRS. ANNE MONTGOMERY KETCHAM (FNP-BC)'s NPI record is not deactivated in the public file.
What services align with MRS. ANNE MONTGOMERY KETCHAM (FNP-BC)'s listing?
MRS. ANNE MONTGOMERY KETCHAM (FNP-BC)'s public classification highlights Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What geographic area is tied to MRS. ANNE MONTGOMERY KETCHAM (FNP-BC)?
MRS. ANNE MONTGOMERY KETCHAM (FNP-BC) is associated with Homewood, Alabama in the same public data insurers reference.
Can I export MRS. ANNE MONTGOMERY KETCHAM (FNP-BC)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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