LYNN D. KETCHUM, M.D. (NPI# 1750563458) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750563458 |
| Entity Type | Organization |
| Organization Name | LYNN D. KETCHUM, M.D. |
| Practice Address |
11111 Nall Ave Ste 114 Leawood KS 66211-1625 |
| Practice Telephone | 9134518567 |
| Practice Fax Number | 9134518568 |
| Mailing Telephone | 9134518567 |
| Mailing Fax Number | 9134518568 |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2008-10-27 |
| Authorized Official Name | LYNN DANIEL KETCHUM (PROPRIETOR) |
| Authorized Official Telephone | 9134518567 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
04-14119 | KS | Allopathic & Osteopathic Physicians |
| Street Address |
11111 NALL AVE STE 114 |
| City | LEAWOOD |
| State | KS |
| Zip Code | 66211-1625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942209366 | Lynn Daniel Ketchum | Specialist | 11111 Nall Ave, Suite 114, Leawood, KS 66211-1925 | 2005-07-18 |
| 1508262999 | Deborah L. Carle, Ph.d., LLC | Psychologist | 11111 Nall Ave, Site 224, Leawood, KS 66211-1924 | 2014-11-12 |
| 1356783146 | Special Care Dental of Kansas, LLC | Dentist | 11111 Nall Ave, Suite 100, Leawood, KS 66211-1924 | 2013-07-23 |
| 1790127512 | Special Care Dental of Missouri LLC | Dental Hygienist | 11111 Nall Ave, Suite 100, Leawood, KS 66211-1924 | 2013-07-22 |
| 1154769735 | Elh Network, LLC | Preferred Provider Organization | 11111 Nall Ave, Suite 220, Leawood, KS 66211-1924 | 2013-06-05 |
| 1215253570 | Angela Giegerich | Nurse Practitioner | 11111 Nall Ave, Suite 222, Leawood, KS 66211-1924 | 2010-04-12 |
| 1306177696 | Ilene Beth Grunspan | Social Worker | 11111 Nall Ave, Suite 103, Leawood, KS 66211-1924 | 2010-01-26 |
| 1447486642 | Ian James Krusich | Dentist | 11111 Nall Ave, 106, Leawood, KS 66211-1924 | 2009-06-03 |
| 1861607657 | Robert R. Edwards | Dentist | 11111 Nall Ave, Suite 114, Leawood, KS 66211-1620 | 2007-05-14 |
| 1366561839 | Suzan K Coulter | Marriage & Family Therapist | 11111 Nall Ave, Suite 112, Leawood, KS 66211-1625 | 2007-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336611821 | Baillie Rose Woydziak | Social Worker | 5805 W 110th Street, Overland Park, KS 66211 | 2018-12-20 |
| 1467920389 | Ku Medwest Ambulatory Surgery Center, LLC | Clinic/Center | 10720 Nall Avenue, Overland Park, KS 66211 | 2018-11-08 |
| 1235615931 | Janice Carollo | Physical Therapy Assistant | 11611 Granada Lane, Leawood, KS 66211 | 2018-07-16 |
| 1720572555 | Trevor Lee Elmer | Physical Therapist | 10777 Nall, 320 - Corporate Medical Plaza Building II, Overland Park, KS 66211 | 2018-06-15 |
| 1043746555 | Overland Park Surgical Suites, LLC | Clinic/Center | 6650 W 110th St Ste 300, Overland Park, KS 66211 | 2017-05-03 |
| 1619313665 | Vcphcs Xiv, LLC | Clinic/Center | 6331 W. 110th Street, Overland Park, KS 66211 | 2013-05-17 |
| 1528334950 | Scott Anthony Hardouin | Surgery | 5100 W 110th St Unit 300, Overland Park, KS 66211 | 2012-03-29 |
| 1386917003 | Children's Physical Therapy Associates | Physical Therapist | 6600 College Boulevard, Suite 307, Overland Park, KS 66211 | 2012-02-10 |
| 1871876250 | Amber Diane Dalzell | Social Worker | 10965 Granada Ln Ste 102, Overland Park, KS 66211 | 2011-09-22 |
| 1912298001 | Stephen Vincent Hiatt | Orthopaedic Surgery | 10701 Nall Avenue, Suite 200, Overland Park, KS 66211 | 2011-04-25 |
| Find all providers in zip 66211 | ||||
| Taxonomy Code | 2082S0105X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| Specialization | Surgery of the Hand |
| A plastic surgeon with additional training in the investigation, preservation, and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770888471 | John Rempel | Plastic Surgery | 6516 E 16th St N, Wichita, KS 67206-1118 | 2011-01-11 |
| 1154305480 | Juan C Nosti | Plastic Surgery | 8901 W 74th St, Suite 350, Shawnee Mission, KS 66204-2204 | 2005-11-30 |
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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.