MICHAEL C KETCHAM (DO) – Obstetrics & Gynecology Physician, NPI 1912910191
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
315 OBSTETRICS/GYNECOLOGY in AR
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Provider Addresses for MICHAEL C KETCHAM (DO)
Jonesboro Post Office, West Broad Street, Jonesboro, Union County, Illinois, 62952, United States
JONESBORO, AR 724031960
Phone: (870) 936-8000
Fax: (870) 934-3631
Type: Mailing
NEA Baptist Clinic, 4802, East Johnson Avenue, Jonesboro, Craighead County, Arkansas, 72401, United States
JONESBORO, AR 72401
Phone: (870) 936-8000
Fax: (870) 934-3631
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 12 Open Payments records for all available years, with a total value of $233.
Total Amount is formed as General ($233) + Research ($0) + Ownership ($0) = $233.
Last reported payment date: 2024-10-09 • Largest payer in this snapshot: Astellas Pharma US Inc ($87).
Total Amount
$233
General + Research + Ownership
Payments
12
Total payment records
General Amount
$233
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Astellas Pharma US Inc | $87 |
| Hologic Sales and Service, LLC | $60 |
| ABBVIE INC. | $33 |
| Exeltis, USA Inc. | $31 |
| Medtronic, Inc. | $21 |
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: 2017-11-27
PECOS data refreshed: 2026-06-15
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20171127002300 | I | Obstetrics/Gynecology | AR | TBD |
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.
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 72403)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OBSTETRICS/GYNECOLOGY | VA | 76830 | Ultrasound pelvis through vagina | 43 | 35 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | AR | |
| Internal Medicine | AR | |
| - | CA | |
| Nurse Practitioner | AR | |
| - | AR | |
| - | TN | |
| - | AR | |
| Nurse Practitioner | TN | |
| Interventional Radiology, Diagnostic Radiology, Diagnostic Radiology, Interventional Radiology | TN | |
| Nurse Practitioner | AR |
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