KIMBERLEE R KETCHERSID (PA) – Physician Assistant, NPI 1831580430

KIMBERLEE R KETCHERSID (PA) is a healthcare provider. based in Pearisburg, Virginia. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 003293 (CT). The NPI Number for KIMBERLEE R KETCHERSID (PA) is 1831580430

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLEE R KETCHERSID (PA)
NPI
1831580430
Phone
(540) 921-6000
Address
159 HARTLEY WAY
Enumeration Date
18 February 2015
Last Update Date
10 May 2018

Doctor Profile

Medical School Name
EMORY UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
8048288737
Graduation Year
2014 (12 years ago)
PAC ID
8224333471
Group Practice PAC ID
4385542117
Professional Enrollment ID
I20180327000117
Address ID
VA232191914RI401XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:11State licenses:2Digital endpointsOther names

4,429 PHYSICIAN ASSISTANT in VA

Provider Addresses for KIMBERLEE R KETCHERSID (PA)

  • 159 HARTLEY WAY

    PEARISBURG, VA 241342471

    Phone: (540) 921-6000

    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: 2018-03-27

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
I20180327000117IPhysician AssistantVATBD

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 24134)

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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: 4385542117View full group profile
NameSpecialtyState
Internal MedicineVA
-VA
Nurse PractitionerVA
Orthopedic SurgeryVA
O T O L A R Y N G O L O G YVA
Diagnostic RadiologyVA
Nurse PractitionerVA
Qualified AudiologistVA
Radiation OncologyVA
O T O L A R Y N G O L O G YVA

Reviews

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Frequently asked questions

What is the 10-digit NPI for KIMBERLEE R KETCHERSID (PA)?
KIMBERLEE R KETCHERSID (PA) — NPI 1831580430 — is the standard way to identify this listing.
Does CMS list KIMBERLEE R KETCHERSID (PA) as active?
Yes — KIMBERLEE R KETCHERSID (PA) is active in the NPI listing used on this page.
What is KIMBERLEE R KETCHERSID (PA) best known for clinically?
Directory data describes KIMBERLEE R KETCHERSID (PA) with Physician Assistant. Clinical services aligned with this taxonomy classification.
What address line appears for KIMBERLEE R KETCHERSID (PA)?
KIMBERLEE R KETCHERSID (PA)'s geographic hint is Pearisburg, Virginia in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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