KEITH A. EGLY
NPI 1790451730
Nurse Practitioner - Family in Churubusco, IN

Q: What is Keith Egly's NPI number?

The NPI number for Keith Egly is 1790451730. It was assigned to this individual provider in the NPPES registry on August 19, 2021.

Q: What is Keith Egly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Keith Egly was last updated on August 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 19, 2021PECOS Enrolled

8415 STATE ROAD 205, CHURUBUSCO, IN 46723(260) 417-2775 Get Directions Write a Review

NPPES record last updated: August 19, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Keith A. Egly NPPES

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

KEITH A. EGLY (NPI 1790451730) is an individual family provider in Churubusco, Indiana, licensed in West Virginia (110355) and active in the NPI registry since August 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790451730

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameKEITH A. EGLY

Location Address8415 STATE ROAD 205Churubusco, IN 46723-9234

Mailing Address8415 State Road 205Churubusco, IN 46723-9234 · (260) 417-2775

Phone(260) 417-2775

Sole ProprietorNo

Enumeration DateAugust 19, 2021

NPPES CertifiedAugust 19, 2021

✔ NPI 1790451730 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in WV · 110355

8415 STATE ROAD 205, Churubusco, IN 46723

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Keith A. Egly is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 46723 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.

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 Keith Egly's NPI number?

The NPI number for Keith Egly is 1790451730. It was assigned to this individual provider in the NPPES registry on August 19, 2021.

Where is Keith Egly located?

Keith Egly practices at 8415 State Road 205, Churubusco, IN 46723. The listed phone number is (260) 417-2775.

What is Keith Egly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Keith Egly enrolled in Medicare?

Yes. Keith Egly is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Keith Egly was last updated on August 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.