Lisa Marie Ketchem, FNP-C - Medicare Nurse Practitioner in Kingsport, TN

Lisa Marie Ketchem, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Kingsport, Tennessee. She graduated from nursing school in 2018 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Tri-cities Observation Services, Pc, Tri-cities Regional Emergency Physicians, Pc, Western Virginia Regional Emergency Physicians Llc and her current practice location is 5039 Andrew St, Kingsport, Tennessee. You can reach out to her office (for appointments etc.) via phone at (423) 817-8615.

Lisa Marie Ketchem is licensed to practice in Tennessee (license number 25202) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1871058263.

Contact Information

Lisa Marie Ketchem, FNP-C
5039 Andrew St,
Kingsport, TN 37660-6500
(423) 817-8615
Not Available

Map and Direction




Provider's Profile

Full NameLisa Marie Ketchem
GenderFemale
SpecialityNurse Practitioner
Experience6 Years
Location5039 Andrew St, Kingsport, Tennessee
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Lisa Marie Ketchem graduated from nursing school in 2018
  NPI Data:
  • NPI Number: 1871058263
  • Provider Enumeration Date: 02/10/2019
  • Last Update Date: 10/18/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 8325472947
  • Enrollment ID: I20200107000986

Medical Identifiers

Medical identifiers for Lisa Marie Ketchem such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1871058263NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 0024184785 (Virginia)Secondary
363LF0000XNurse Practitioner - Family 25202 (Tennessee)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Tri-cities Observation Services, Pc327481971913
Tri-cities Regional Emergency Physicians, Pc3678859477127
Western Virginia Regional Emergency Physicians Llc418399122775

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lisa Marie Ketchem allows following entities to bill medicare on her behalf.
Entity NameSoutheastern Physician Services Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1083835441
PECOS PAC ID: 0042307852
Enrollment ID: O20071025000571
Entity NameTri-cities Regional Emergency Physicians, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1063950046
PECOS PAC ID: 3678859477
Enrollment ID: O20170410002399
Entity NameTri-cities Observation Services, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1154860146
PECOS PAC ID: 3274819719
Enrollment ID: O20170417001080

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lisa Marie Ketchem is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Lisa Marie Ketchem, FNP-C
5039 Andrew St,
Kingsport, TN 37660-6500

Ph: (423) 817-8615
Lisa Marie Ketchem, FNP-C
5039 Andrew St,
Kingsport, TN 37660-6500

Ph: (423) 817-8615

Reviews and Comments


Nurse Practitioner Nurses in Kingsport, TN

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Sherry Lynn Goode, NP
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Amanda M Malone, MSN, FNP-BC
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Phone: --    
Mary Renee Mcnees, FNP-BC
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Medicare: Accepting Medicare Assignments
Practice Location: 2300 Pavilion Drive, Kingsport, TN 37660
Phone: 423-765-9655    Fax: 423-979-6333

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.