Active NPI
James A Kilgore, MD
- Plastic and Reconstructive Surgery Physician
- Tualatin, OR
National Provider Identifier
1003980889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- MD13741
- Practice address
- 19250 SW 65TH Ave #365
Tualatin, OR 97062 - Phone
- (503) 691-0364
- Fax
- (503) 612-6663
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | MD13741 | OR | Primary |
Addresses
Primary practice location
19250 SW 65TH Ave #365
Tualatin, OR 97062
Mailing address
19875 SW 49TH Ave
Tualatin, OR 97062
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21950 1 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD13741 | OR | MD | Plastic and Reconstructive Surgery Physician |
| 13741 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003980889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19875 SW 49TH AVE",
"city": "TUALATIN",
"state": "OR",
"postal_code": "97062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19250 SW 65TH AVE #365",
"city": "TUALATIN",
"state": "OR",
"postal_code": "97062",
"telephone_number": "503-691-0364",
"fax_number": "503-612-6663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILGORE",
"first_name": "JAMES",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "OR",
"license": "MD13741",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "21950 1",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tualatin, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.