Individual provider Active NPI

Brooke Marie Keene, NP

  • Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1144096363
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71014696A Issued in IN
Practice address
8911 Liberty Mills Rd
Fort Wayne, IN 46804-6311
Phone
(260) 373-9465
Fax
(260) 373-9449
NPI assigned
Nov 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71014696A IN Primary

Addresses

Primary practice location

8911 Liberty Mills Rd
Fort Wayne, IN 46804-6311

Mailing address

PO Box 236
Lagrange, IN 46761-0236
Phone (260) 463-2133

Other practice location 1

2500 N Detroit St
LaGrange, IN 46761-1158
Phone (260) 463-2133 ext. 111

Other names 1

  • Brooke Conrad Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240104000505 IN Practitioner - Nurse Practitioner 6103277157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Internal Medicine Associates, PCGroup PAC ID 7113830688, 52 clinicians
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians

Practice addresses (Care Compare)

2500 N Detroit St
Lagrange, IN 46761-1158
Phone (260) 463-2133

817 Trail Ridge Rd
Albion, IN 46701-1534
Phone (260) 373-9590

8911 Liberty Mills Rd
Fort Wayne, IN 46804-6311
Phone (260) 373-9465

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Internal Medicine Associates, PC Nurse Practitioner CurrentSince Jan 1, 2024 Accepting new patients
Northeast Internal Medicine Associates, PC PastSince Dec 3, 2023 Accepting new patients

Locations

2500 N Detroit St
Lagrange, IN 46761
Phone (260) 463-2133

Interoperability endpoints

  • Direct secure messaging: bkeene575309@direct.parkviewexchange.com

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1701216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1144096363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 236",
            "city": "LAGRANGE",
            "state": "IN",
            "postal_code": "467610236",
            "telephone_number": "260-463-2133",
            "fax_number": "206-463-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8911 LIBERTY MILLS RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046311",
            "telephone_number": "260-373-9465",
            "fax_number": "260-373-9449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N Detroit St",
            "address_purpose": "LOCATION",
            "city": "LaGrange",
            "state": "IN",
            "postal_code": "467611158",
            "country_code": "US",
            "telephone_number": "260-463-2133 x111",
            "fax_number": "260-463-3775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEENE",
        "first_name": "BROOKE",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-29",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71014696A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "CONRAD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.