Keith Nalley, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02002091A Issued in IN

Practice address

4111 Franklin St
Michigan City, IN 46360-7803

Phone

(219) 873-2919

Fax

(219) 873-2909

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Osteopathic Manipulative Medicine

Education

Midwestern University, Chicago College of Osteopathic Med, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Franciscan Physician Network

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1225327984
  Medicare reassignment Care Compare group NPD
• Community Care Network Inc

  dba Powers Health Medical Group

  • Family Medicine Physician
  • Saint John, IN
  • NPI 1457610487
  Medicare reassignment NPD
• Franciscan Physician Network

  dba Franciscan Immediate Care

  • Urgent Care Clinic/Center
  • Mishawaka, IN
  • NPI 1366879009
  NPD
• Franciscan Physician Network

  • Clinic/Center
  • Lafayette, IN
  • NPI 1992543250
  NPD

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1609913730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 FRANKLIN ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607803",
            "telephone_number": "219-873-2919",
            "fax_number": "219-873-2909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7651 Harvest Dr",
            "address_purpose": "LOCATION",
            "city": "Schererville",
            "state": "IN",
            "postal_code": "46375",
            "country_code": "US",
            "telephone_number": "219-322-5723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7501 W 15th Ave",
            "address_purpose": "LOCATION",
            "city": "Gary",
            "state": "IN",
            "postal_code": "46406",
            "country_code": "US",
            "telephone_number": "219-977-2090",
            "fax_number": "219-977-2091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NALLEY",
        "first_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "02002091A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02002091A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.