Data Notice: All results sourced from the public CMS NPPES NPI Registry (45 CFR Part 162) — for healthcare administrative use only (credentialing, billing, insurance verification). Not for law enforcement or legal proceedings. Not affiliated with CMS, HHS, or the US Government. Verify critical details at npiregistry.cms.hhs.gov. No queries stored.
Export Provider Record NPI 1023712874
Carl Anderson KetchamDO
Active
NPI Number1023712874
NPI TypeNPI-1 Individual
SpecialtyStudent in an Organized Health Care Education/Training Program
Provider Details
NPI1023712874
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2023-03-27
Last Updated2023-08-01
Mailing Address2101 W Warm Springs Rd Apt 3314
Henderson, NV 89014-5517
United States
📍 View Map
Primary Practice Address1524 Pinto Ln Fl 2
Las Vegas, NV 89106-4195
United States
Phone: (702) 992-6888
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes390200000X – Student in an Organized Health Care Education/Training Program
Export Provider Record NPI 1023712874
Search for More Providers
Use our free NPI Lookup tool to find any healthcare provider in the NPPES registry. Search NPI →

About NPI 1023712874

Carl Anderson Ketcham DO is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1023712874. The primary specialty listed is Student in an Organized Health Care Education/Training Program. The provider is located in Las Vegas, NV. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2023-03-27. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1023712874?

NPI 1023712874 belongs to Carl Anderson Ketcham DO, a Student in an Organized Health Care Education/Training Program in Las Vegas, NV. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1023712874 active?

The current status of NPI 1023712874 in the NPPES registry is Active. The record was last updated on 2023-08-01.

What specialty is NPI 1023712874?

NPI 1023712874 is classified under the taxonomy Student in an Organized Health Care Education/Training Program. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1023712874?

You can verify NPI 1023712874 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1023712874?

The primary practice address on file for NPI 1023712874 is 1524 Pinto Ln Fl 2, Las Vegas, NV 89106-4195. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1023712874 issued?

NPI 1023712874 was first issued (enumerated) on 2023-03-27. The NPPES record was last updated on 2023-08-01.

Practice Location Map

Carl Anderson Ketcham is located at 1524 Pinto Ln Fl 2, Las Vegas, NV. Use the map below to find directions or verify the practice location.

📍 1524 Pinto Ln Fl 2, Las Vegas, NV 89106-4195  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Carl Anderson Ketcham. All records sourced from the CMS NPPES registry.

Data Verified from CMS NPPES Last synced: 2026-06-10 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162