DR. KEITH NALLEY (D.O.) – Family Medicine Physician, NPI 1609913730

DR. KEITH NALLEY (D.O.) is a healthcare provider. based in Michigan city, Indiana. specializing in FAMILY PRACTICE, OSTEOPATHIC MANIPULATIVE MEDICINE. They hold the professional credentials D.O.. They hold a License No. 02002091A (IN). The NPI Number for DR. KEITH NALLEY (D.O.) is 1609913730

Main info

Male
Sole Proprietor
29 Years Of Experience
Accepts Medicare Assignment
Name
DR. KEITH NALLEY (D.O.)
NPI
1609913730
Phone
(219) 873-2919
Address
4111 FRANKLIN ST
Enumeration Date
30 January 2007
Last Update Date
20 November 2023

Doctor Profile

Medical School Name
MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Secondary Phone
2198732919
Graduation Year
1997 (29 years ago)
PAC ID
1153490453
Group Practice PAC ID
3072790682
Professional Enrollment ID
I20080513000093
Address ID
IN463607803MI4111XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,862 FAMILY PRACTICE in IN

Provider Addresses for DR. KEITH NALLEY (D.O.)

  • 4111 FRANKLIN ST

    MICHIGAN CITY, IN 463607803

    Phone: (219) 873-2919

    Fax: (219) 873-2909

    Type: Location

  • PO BOX 781076

    DETROIT, MI 482781076

    Phone: (317) 528-4800

    Fax: (317) 865-1479

    Type: Mailing

  • Harvest Drive, Schererville, Lake County, Indiana, 46307, United States

    SCHERERVILLE, IN 463753476

    Phone: (219) 322-5723

    Type: Mailing

  • 7651 Harvest Dr

    Schererville, IN 46375

    Phone: (219) 322-5723

    Type: Location

  • 7501 W 15th Ave

    Gary, IN 46406

    Phone: (219) 977-2090

    Fax: (219) 977-2091

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2008-05-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080513000093IFamily PracticeINTBD

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.

Verify on CMS Revalidation Lookup Tool

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 46360)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3072790682View full group profile

Reviews

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Frequently asked questions

What federal number belongs to DR. KEITH NALLEY (D.O.)?
The federal identifier for DR. KEITH NALLEY (D.O.) is NPI 1609913730.
Does this profile mean DR. KEITH NALLEY (D.O.) is currently active?
Yes — DR. KEITH NALLEY (D.O.) appears active in the national provider directory.
Can you summarize DR. KEITH NALLEY (D.O.)'s specialty in plain language?
Clinically, the directory lists DR. KEITH NALLEY (D.O.) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where does public data place DR. KEITH NALLEY (D.O.)?
The snapshot lists Michigan City, Indiana for DR. KEITH NALLEY (D.O.); download NPPES for the complete set.
How can I contact DR. KEITH NALLEY (D.O.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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