KEVIN L KETCHUM (M.D.) – Diagnostic Radiology Physician, NPI 1396717831

KEVIN L KETCHUM (M.D.) is a healthcare provider. based in Fond du lac, Wisconsin. specializing in Diagnostic Radiology Physician. They hold the professional credentials M.D.. They hold a License No. 38030 (WI). The NPI Number for KEVIN L KETCHUM (M.D.) is 1396717831

Main info

Male
39 Years Of Experience
Accepts Medicare Assignment
Name
KEVIN L KETCHUM (M.D.)
NPI
1396717831
Phone
(920) 921-5676
Address
481 E DIVISION ST
Enumeration Date
7 February 2006
Last Update Date
5 January 2009

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9072288300
Graduation Year
1987 (39 years ago)
PAC ID
9234028846
Group Practice PAC ID
9436067618
Professional Enrollment ID
I20111110000780
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for KEVIN L KETCHUM (M.D.)

  • Fond-du-Lac, Northern Saskatchewan Administration District, Saskatchewan, Canada

    FOND DU LAC, WI 549353748

    Phone: (920) 921-5676

    Fax: (920) 921-2684

    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.

No Medicare enrollment or revalidation data available for this provider in our database.

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 54935)

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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: 9436067618View full group profile
NameSpecialtyState
Nurse PractitionerAK
Diagnostic RadiologyAK
Diagnostic RadiologyWA
Diagnostic RadiologyWA
A N E S T H E S I O L O G YHI
Diagnostic RadiologyWA
Cardiovascular Disease (Cardiology), Internal MedicineWA
Interventional RadiologyIL
O B S T E T R I C S/ G Y N E C O L O G YAK
Physician AssistantAZ

Reviews

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Frequently asked questions

How is KEVIN L KETCHUM (M.D.) identified in CMS data?
CMS-hosted NPPES data lists KEVIN L KETCHUM (M.D.) with NPI 1396717831.
Does the file indicate KEVIN L KETCHUM (M.D.) is practicing under active NPI?
Directory data currently reports KEVIN L KETCHUM (M.D.) as active.
What is KEVIN L KETCHUM (M.D.)'s specialty?
The listing groups KEVIN L KETCHUM (M.D.) with Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
What area does KEVIN L KETCHUM (M.D.) serve?
KEVIN L KETCHUM (M.D.)'s listing highlights Fond Du Lac, Wisconsin; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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