NPIMap

Individual provider Active NPI

Keith Peachey, M.D.

  • Family Medicine Physician
  • Galesburg, IL
National Provider Identifier
1184623746
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
834 N Seminary St
201
Galesburg, IL 61401-2852
Phone
(309) 343-7135
NPI assigned
Jul 18, 2005
Last updated
Dec 3, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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 IL Primary

Addresses

Primary practice location

834 N Seminary St
201
Galesburg, IL 61401-2852

Mailing address

834 N Seminary St
201
Galesburg, IL 61401-2852
Phone (309) 343-7135

Other identifiers 1

IdentifierTypeStateIssuer
0360811401MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20040921000457 IL Practitioner - Family Practice 5294635504 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Mary Medical CenterGroup PAC ID 8628038015, 52 clinicians

Practice addresses (Care Compare)

104 S Broadway St
Knoxville, IL 61448
Phone (309) 289-2335

834 N Seminary
Suite 401 Osf Healthcare Medical Group Ga
Galesburg, IL 61401-0500
Phone (309) 446-3305

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary Medical Center CurrentSince Dec 1, 2022 Accepting new patients
St Mary Medical Center Family Medicine CurrentSince Dec 1, 2022 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Sep 1, 2020 Accepting new patients
St Mary Medical Center Current Accepting new patients
St Mary Medical Center Past Accepting new patients

Locations

695 N Kellogg St
Galesburg, IL 61401
Phone (309) 343-0557

834 N Seminary St
Ste 201
Galesburg, IL 61401
Phone (309) 343-7130

834 N Seminary St
Ste 304
Galesburg, IL 61401
Phone (309) 342-2144

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Interoperability endpoints

  • Direct secure messaging: kpeachey@yourcarecommunity.org

Organizations & group practices 6

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 6

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1184623746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 N SEMINARY ST",
            "address_2": "201",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012852",
            "telephone_number": "309-343-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 N SEMINARY ST",
            "address_2": "201",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012852",
            "telephone_number": "309-343-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACHEY",
        "first_name": "KEITH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360811401",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

Verify at the official NPI Registry.