Individual provider Active NPI

Edward Wylly Killorin Jr., MD

  • Urology Physician
  • Columbus, GA
National Provider Identifier
1013981968
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
032219 Issued in GA
Practice address
1538 13TH Avenue
BLD a
Columbus, GA 31901
Phone
(706) 323-4000
Fax
(706) 323-4848
NPI assigned
Feb 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 032219 GA Primary

Addresses

Primary practice location

1538 13TH Avenue
BLD a
Columbus, GA 31901

Mailing address

2300 Manchester Expy Ste 2001a
Columbus, GA 31904-6802
Phone (706) 320-3126

Other practice location 1

2548 Weems Rd
Columbus, GA 31909-6248
Phone (706) 320-3126

Other practice location 2

2300 Manchester Expy Ste A002
Columbus, GA 31904-6805
Phone (706) 320-3203

Other identifiers 1

IdentifierTypeStateIssuer
005420778MedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051202000018 GA Practitioner - Urology 2264452531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Medical College of Georgia School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Francis Physician Practices LLCGroup PAC ID 8729381033, 217 clinicians

Practice addresses (Care Compare)

2122 Manchester Expy
Columbus, GA 31904-6878
Phone (706) 320-2773

2300 Manchester Expy
Columbus, GA 31904-6805

Hospital & facility affiliations

  • Prohealth Home Health-Georgia, LLC Home health agency, Columbus, GA, CCN 117140
  • Prohealth Home Health Home health agency, Auburn, AL, CCN 017063
  • St Francis Hospital- Emory Healthcare Hospital, Columbus, GA, CCN 110129
  • Piedmont Columbus Regional Midtown Hospital, Columbus, GA, CCN 110064

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032219GAMDUrology Physician
12590GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Physician Practices LLC CurrentSince Oct 1, 2018 Accepting new patients
St. Francis Physician Practices LLC CurrentSince Oct 1, 2018 Accepting new patients
St. Francis Physician Practices LLC Current Accepting new patients
St. Francis Center for Surgical Care, LLC Past Accepting new patients

Locations

2548 Weems Rd
Columbus, GA 31909
Phone (404) 265-4000

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

2300 Manchester Expy
Ste A002
Columbus, GA 31904
Phone (706) 320-3203

2300 Manchester Expy
Ste 2001A
Columbus, GA 31904
Phone (706) 320-3126

Organizations & group practices 4

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

Hospital & facility affiliations 4

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": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1013981968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 MANCHESTER EXPY STE 2001A",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046802",
            "telephone_number": "706-320-3126",
            "fax_number": "706-320-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1538 13TH AVENUE",
            "address_2": "BLD A",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31901",
            "telephone_number": "706-323-4000",
            "fax_number": "706-323-4848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2548 Weems Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319096248",
            "country_code": "US",
            "telephone_number": "706-320-3126",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2300 Manchester Expy Ste A002",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319046805",
            "country_code": "US",
            "telephone_number": "706-320-3203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLORIN",
        "first_name": "EDWARD",
        "middle_name": "WYLLY",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "032219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005420778",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.