Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Keith Ennis, MD

Individual provider Family Medicine Physician · NPI 1033292628

Keith Ennis, MD is an Emergency Medicine in Kokomo, Indiana. Graduated from Indiana University School of Medicine in 1991, 35 years ago. Practices with St Vincent Physician Services Hospital and Health Care Center, a 282-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
35
Trained at
Indiana University School of Medicine
Licensed in
IN
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1907 W Sycamore St
Kokomo, IN 46901-5148
Phone: (765) 456-5433
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 01040472A (IN)

Record details

NPI number1033292628
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 24, 2006
Last updated in NPPESJune 20, 2022
Certification dateJune 20, 2022
Mailing address1907 W Sycamore St, Kokomo, IN 46901-5148

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Also practisesFAMILY PRACTICE
Medical schoolINDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduated 1991 (35 years in practice)
Group practice St Vincent Physician Services Hospital And Health Care Center — 282 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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