NPIMap

Individual provider Active NPI

Gary J Keepes, M.D.

  • Family Medicine Physician
  • Petersburg, IN
National Provider Identifier
1104829480
Registry record updated Jan 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01044355A Issued in IN
Practice address
106 W Pike Ave
Petersburg, IN 47567-8750
Phone
(812) 354-1052
Fax
(812) 354-8280
NPI assigned
May 31, 2005
Last updated
Jan 3, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01044355A IN Primary

Addresses

Primary practice location

106 W Pike Ave
Petersburg, IN 47567-8750

Mailing address

PO Box 1510
Evansville, IN 47706-1510
Phone (812) 354-1052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031210000983 IN Practitioner - Family Practice 8527964485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Clinic IncGroup PAC ID 3375610116, 411 clinicians

Practice addresses (Care Compare)

1004 E Illinois St
Petersburg, IN 47567-8068
Phone (812) 354-1052

1204 Williams St
Oakland City, IN 47660-1001
Phone (812) 749-6187

421 Chestnut St
Evansville, IN 47713-1227
Phone (812) 426-6645

600 S State Rd
Suite 57
Washington, IN 47501-4371
Phone (812) 257-1052

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01044355AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic Inc Family Medicine CurrentSince Oct 1, 2008 Accepting new patients
Deaconess Clinic Inc. CurrentSince Oct 1, 2008 Accepting new patients
Major Hospital Past Accepting new patients

Locations

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

106 W Pike Ave
Petersburg, IN 47567
Phone (812) 354-1052

Interoperability endpoints

  • Direct secure messaging: gkeepes2129@direct.deaconess.com

Ownership & related parties

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Deaconess Clinic IPetersburg, IN, CCN 153843 Rural health clinic Corporate Director Nov 20, 2008
Deaconess Clinic Oakland CityOakland City, IN, CCN 153936 Rural health clinic Corporate Director Oct 1, 2019
Deaconess Clinic Sherman DrivePrinceton, IN, CCN 153934 Rural health clinic Corporate Director Oct 1, 2019
Deaconess Clinic Ft. BranchFort Branch, IN, CCN 153933 Rural health clinic Corporate Director Oct 1, 2019
Deaconess Clinic Vail StreetPrinceton, IN, CCN 153935 Rural health clinic Corporate Director Oct 1, 2019
Deaconess Clinic SebreeSebree, KY, CCN B03929 Rural health clinic Corporate Director Oct 1, 2019
Deaconess Clinic Dixon RHCDixon, KY, CCN B03930 Rural health clinic Corporate Director Oct 1, 2019
Deaconess Clinic MorganfieldMorganfield, KY, CCN 183968 Rural health clinic Corporate Director Oct 1, 2019

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357171200000",
    "number": "1104829480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-354-1052",
            "fax_number": "812-354-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 W PIKE AVE",
            "city": "PETERSBURG",
            "state": "IN",
            "postal_code": "475678750",
            "telephone_number": "812-354-1052",
            "fax_number": "812-354-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEPES",
        "first_name": "GARY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2013-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01044355A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, IN

Sources for this page

Verify at the official NPI Registry.