NPIMap

Individual provider Active NPI

Clinton Taylor Kilcrease, MD

  • Family Medicine Physician
  • Luverne, AL
National Provider Identifier
1003420464
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.43478 Issued in AL
Practice address
1704 S Forest Ave
Luverne, AL 36049-7306
Phone
(334) 335-3383
Fax
(334) 335-3078
NPI assigned
Sep 3, 2020
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD.43478 AL Primary

Addresses

Primary practice location

1704 S Forest Ave
Luverne, AL 36049-7306

Mailing address

1704 S Forest Ave
Luverne, AL 36049-7306
Phone (334) 335-3383

Other practice location 1

4371 Narrow Lane Rd Ste 100
Montgomery, AL 36116-2975
Phone (334) 613-3680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230711000507 AL Practitioner - Family Practice 1052770948 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Alabama School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Practice Associates LLCGroup PAC ID 0840295192, 6 clinicians

Practice addresses (Care Compare)

1704 S Forest Ave
Luverne, AL 36049-7306
Phone (334) 335-3383

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Associates LLC Family Medicine CurrentSince Jul 5, 2023 Accepting new patients
Crenshaw County Health Care Authority CurrentSince Dec 1, 2025 Accepting new patients
Luverne Health and Rehabilitation, LLC Past Accepting new patients

Locations

9373 N Main St
Brantley, AL 36009
Phone (334) 527-0101

101 Hospital Dr
Luverne, AL 36049
Phone (334) 335-3374

1704 S Forest Ave
Luverne, AL 36049
Phone (334) 335-3383

Networks

  • MS PPO
  • AL HMO D-SNP
  • devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
  • MS PPO C-SNP
  • FL HMO D-SNP
  • TN PPO C-SNP
  • MS PPO D-SNP
  • AL HMO
  • devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
  • devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
  • FL PPO
  • devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
  • devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
  • TN PPO

Interoperability endpoints

  • Direct secure messaging: clinton.kilcrease@fpa.direct.medconnecthealth.com
  • FHIR API: https://api.platform.athenahealth.com/3503/brand/10/csg/161/fhir/r4
  • FHIR API: https://fhir-usa.unify.chbase.com/org/crensch-bd308947
  • FHIR API: https://fhir-usa.unify.chbase.com/org/troyreg-8017c011

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1003420464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 S FOREST AVE",
            "city": "LUVERNE",
            "state": "AL",
            "postal_code": "360497306",
            "telephone_number": "334-335-3383",
            "fax_number": "334-335-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 S FOREST AVE",
            "city": "LUVERNE",
            "state": "AL",
            "postal_code": "360497306",
            "telephone_number": "334-335-3383",
            "fax_number": "334-335-3078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4371 Narrow Lane Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "361162975",
            "country_code": "US",
            "telephone_number": "334-613-3680",
            "fax_number": "334-613-3685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILCREASE",
        "first_name": "CLINTON",
        "middle_name": "TAYLOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-03",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD.43478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Luverne, AL

Sources for this page

Verify at the official NPI Registry.