MR. KEITH MICHAEL DOUBET (FNP-C) – Family Nurse Practitioner, NPI 1225735533
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for MR. KEITH MICHAEL DOUBET (FNP-C)
PO BOX 9727
PEORIA, IL 616129727
Phone: (309) 886-9172
Type: Mailing
256 S SOANGETAHA RD
GALESBURG, IL 614015586
Phone: (309) 233-2836
Fax: (888) 464-1233
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $111.
Total Amount is formed as General ($111) + Research ($0) + Ownership ($0) = $111.
Last reported payment date: 2023-07-13 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($111).
Total Amount
$111
General + Research + Ownership
Payments
1
Total payment records
General Amount
$111
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-07-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| E.R. Squibb & Sons, L.L.C. | $111 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-02-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230403001529 | I | Nurse Practitioner | IL | TBD |
| I20250203002264 | I | Nurse Practitioner | IA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 61612)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Qualified Audiologist | IL | |
| Certified Clinical Nurse Specialist (Cns) | IL | |
| Family Practice | IL | |
| Nurse Practitioner | IL | |
| Family Practice | GA | |
| Physician Assistant | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Physical Therapist In Private Practice | IL |
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