Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1598742702 Deactivated / Inactive NPI Male Practitioner

Dr. Donn Ketcham , MD

General Practice • Allendale, MI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Donn Ketcham has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 29, 2005
NPI Deactivation Date October 13, 2023
Total Practice Duration ~18 Years of Practice (2005 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Donn Ketcham, MD was a registered General Practice practicing in Allendale, MI. Throughout an active medical career spanning 18 years, Dr. Ketcham provided care at the practice location at 11315 EDGEWATER DR until profile deactivation on 2023-10-13.

Practice Location & Contact Primary Location

Practice Address

11315 Edgewater Dr

Allendale, MI 494019396

Telephone 6168952000
Fax 6168952009
Associated Practice Facility / Clinic
🏢 Allendale Family Practice Facility NPI 1386633675

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Allendale, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 29.4 Yrs
Regional Practice Density
1 Specialists

Practicing in Allendale, MI (445 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License MI 4301023446

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
Carl Piersma , PA-C

Physician Assistant

NPI 1093861593

Physician Assistant (Certified)

Samantha Mette , FNP-C

Nurse Practitioner - Family

NPI 1205477924

Family Nurse Practitioner (Certified)

Dr. John Lemke , DO

Family Medicine

NPI 1205884343

Doctor of Osteopathic Medicine (D.O.)

Dr. Matthew Boyd , MD

Family Medicine

NPI 1558580977

Doctor of Medicine (M.D.)

Taylor Vos , PA-C

Physician Assistant

NPI 1629700976

Physician Assistant (Certified)

Julie Brubaker , NP

Nurse Practitioner - Family

NPI 1669456927

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 13, 2023

Record deactivated on October 13, 2023

NPI Profile Active October 19, 2007

NPI status registered as active in NPPES database

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Updated Practice Location October 19, 2007

Registered at 11315 EDGEWATER DR, ALLENDALE, MI 494019396 (Tel: 6168952000)

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Updated Business Mailing Address October 19, 2007

Registered at 11315 EDGEWATER DR, ALLENDALE, MI 494019396 (Tel: 6168952000)

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Provider Name / Credentials Updated October 19, 2007

Recorded as DONN KETCHAM, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 19, 2007

General Practice (License #4301023446 in MI)

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Initial NPI Registration & Enumeration December 29, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1598742702
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 29, 2005
Last Update: October 19, 2007
Deactivation Date: October 13, 2023

Mailing Address

11315 Edgewater Dr

Allendale, MI 494019396

Phone: 6168952000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.