NPIMap

Individual provider Active NPI

Kevin David Keagle, D.O.

  • Family Medicine Physician
  • Wilmington, NC
National Provider Identifier
1841308277
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2023-02548 Issued in NC
Practice address
1984 S 16TH St Ste 1
Wilmington, NC 28401-6674
Phone
(910) 452-8633
Fax
(901) 452-8569
NPI assigned
Aug 27, 2006
Last updated
May 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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 2023-02548 NC Primary

Addresses

Primary practice location

1984 S 16TH St Ste 1
Wilmington, NC 28401-6674

Mailing address

PO Box 15109
Wilmington, NC 28408-5109
Phone (910) 392-2525

Other identifiers 2

IdentifierTypeStateIssuer
NNT761AOtherNCMEDICARE
1841308277MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040902000008 IL Practitioner - Family PracticePractitioner - Emergency Medicine 1456326313 Reassigns benefits to 3 organizations
I20230926003377 NC Practitioner - Family Practice 1456326313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Chicago College of Osteopathy, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Health Associates, P.a.Group PAC ID 6406867191, 15 clinicians

Practice addresses (Care Compare)

1984 S 16TH St
Suite 1
Wilmington, NC 28401-6674
Phone (910) 452-8633

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
23.35 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
77.85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023-02548NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Hospital Association CurrentSince Oct 16, 2004 Accepting new patients
Central Dupage Physician Group Family Medicine CurrentSince Apr 4, 2012 Accepting new patients
Senior Health Associates, P.a. Family Medicine CurrentSince Aug 22, 2023 Accepting new patients
Winfield Pathology Consultants, S.C. Current Accepting new patients
Central Dupage Hospital Association CurrentSince Oct 16, 2004 Accepting new patients
Dupage Medical Group LTD CurrentSince Feb 5, 2018 Accepting new patients
Central Dupage Physician Group CurrentSince Apr 4, 2012 Accepting new patients
Dupage Medical Group LTD CurrentSince Feb 5, 2018 Accepting new patients
Wilmington NC Opco LLC Past Accepting new patients
WLC Opco LLC Past Accepting new patients
Accordius Health at Wilmington, LLC Past Accepting new patients
Kenansville Opco LLC Past Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

Dept 5777
Carol Stream, IL 60122

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

1020 E Ogden Ave
Ste 115
Naperville, IL 60563
Phone (630) 355-1300

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

0N025 Winfield Rd
Winfield, IL 60190
Phone (630) 832-0050

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

25 N Winfield Rd
Ste 401
Winfield, IL 60190
Phone (630) 933-4200

7409 Woodridge Dr
Ste A
Woodridge, IL 60517

1709 S 16th St
Ste A
Wilmington, NC 28401
Phone (910) 452-8633

1984 S 16th St
Ste 1
Wilmington, NC 28401
Phone (910) 452-8633

Interoperability endpoints

  • Direct secure messaging: kkeagle1247961@direct.novanthealth.org

Organizations & group practices 12

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 7

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": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1841308277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15109",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284085109",
            "telephone_number": "910-392-2525",
            "fax_number": "910-392-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1984 S 16TH ST STE 1",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016674",
            "telephone_number": "910-452-8633",
            "fax_number": "901-452-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEAGLE",
        "first_name": "KEVIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-27",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2023-02548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "NNT761A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841308277",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.