Keith Priddle, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71007578A Issued in IN

Practice address

747 E County Line Rd Ste B
Greenwood, IN 46143-1082

Phone

(317) 789-9600

Fax

(317) 789-0600

NPI assigned

Jan 31, 2017

Last updated

Mar 31, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Premier Family Medicine LLCGroup PAC ID 9638308422, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital South, Inc. Hospital, Indianapolis, IN, CCN 150128
• Franciscan Health Indianapolis Hospital, Indianapolis, IN, CCN 150162

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpriddle@amazing-direct.com

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.

• Premier Family Medicine, LLC

  • Family Medicine Physician
  • Greenwood, IN
  • NPI 1093145427
  Medicare reassignment Care Compare group NPD
• Oliver Family Healthcare PC

  • Family Nurse Practitioner
  • Indianapolis, IN
  • NPI 1083667653
  Medicare reassignment NPD
• Cathy Yoder MD, LLC

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1144574070
  NPD
• Eagle Creek Urgent Care LLC

  • Urgent Care Clinic/Center
  • Indianapolis, IN
  • NPI 1316715105
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

• Community Hospital South, Inc.

  dba Community Hospital South

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1235109778
  Care Compare affiliation
• Franciscan Health Indianapolis & Mooresville

  dba Franciscan Health Indianapolis Orthopedic Hospital

  • General Acute Care Hospital
  • Carmel, IN
  • NPI 1376214981
  Care Compare affiliation
• Franciscan Health Indianapolis & Mooresville

  dba Franciscan Health - Indianapolis

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1386749893
  Care Compare affiliation

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1235676099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 E COUNTY LINE RD STE B",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431082",
            "telephone_number": "317-789-9600",
            "fax_number": "317-789-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 E COUNTY LINE RD STE B",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431082",
            "telephone_number": "317-789-9600",
            "fax_number": "317-789-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDDLE",
        "first_name": "KEITH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71007578A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28205187A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KPRIDDLE@AMAZING-DIRECT.COM",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "747 E County Line Rd Ste B",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461431082",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Updox.com",
            "affiliation": "Y",
            "endpointDescription": "Practice Portal",
            "affiliationName": "Premier Family Medicine, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PDF",
            "address_1": "747 E County Line Rd Ste B",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461431082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lillian Price- Maze
• Adam Price, DO
• Mary Price
• Tracy R Price, M.D.
• Megan Marie Prickel, MA, BCBA
• Pride Transportation
• Primeaxis Wellcare LLC
• Primebridge Medical LLC
• Robert I. Prince, MD
• Prismguardianmedical LLC

• Nurse Practitioner in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.