MR. WILLARD KEITH CUPP III PMHNP
NPI 1265021406
Nurse Practitioner - Psychiatric/Mental Health in Elkhart, IN

Active since January 12, 2021PECOS EnrolledAccepts Medicare Assignment
236 SIMPSON AVE, ELKHART, IN 46516(574) 293-0052 Get Directions Write a Review

NPPES record last updated: November 3, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 3, 2023, Jan 12, 2021 (2 updates tracked since 2021).

About Mr. Willard Keith Cupp Iii Pmhnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. WILLARD KEITH CUPP III PMHNP (NPI 1265021406) is an individual psychiatric/mental health provider in Elkhart, Indiana, licensed in Indiana (71010753A) and active in the NPI registry since January 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1265021406
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameMR. WILLARD KEITH CUPP IIICredential: PMHNP
Location Address236 SIMPSON AVEElkhart, IN 46516-4666
Mailing Address236 Simpson AveElkhart, IN 46516-4666 · (574) 968-2461
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJanuary 12, 2021
Last NPPES UpdateNovember 3, 20232 updates tracked since enumeration
NPPES CertifiedAugust 3, 2021
NPI 1265021406 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License Licensed in IN · 71010753A
236 SIMPSON AVE, Elkhart, IN 46516

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mr. Willard Keith Cupp Iii Pmhnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173937299
PECOS Enrollment IDI20210202001233
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46516 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Community Health)
236 SIMPSON AVE
ELKHART, IN 46516
Nurse Practitioner (Family)
236 SIMPSON AVE
ELKHART, IN 46516
Psychologist (Intellectual and Developmental Disabilities)
236 SIMPSON AVE
ELKHART, IN 46516
Internal Medicine
236 SIMPSON AVE
ELKHART, IN 46516
Dentist
236 SIMPSON AVE
ELKHART, IN 46516
Nurse Practitioner (Family)
236 SIMPSON AVE
ELKHART, IN 46516
Nurse Practitioner (Psychiatric/Mental Health)
236 SIMPSON AVE
ELKHART, IN 46516
Nurse Practitioner (Family)
236 SIMPSON AVE
ELKHART, IN 46516

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Willard Cupp's NPI number?

The NPI number for Willard Cupp is 1265021406. It was assigned to this individual provider in the NPPES registry on January 12, 2021.

Where is Willard Cupp located?

Willard Cupp practices at 236 Simpson Ave, Elkhart, IN 46516. The listed phone number is (574) 293-0052.

What is Willard Cupp's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Willard Cupp enrolled in Medicare?

Yes. Willard Cupp is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Willard Cupp accept?

Health plans from Anthem Blue Cross and Blue Shield and CareSource list Willard Cupp as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Willard Cupp was last updated on November 3, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.