Jackson Killian

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10299 Issued in SC

Practice address

501 Forest LN
Clemson, SC 29631-2621

Phone

(864) 654-2001

NPI assigned

Jul 14, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Excel Rehabilitation and SportsGroup PAC ID 1759481559, 53 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Excel Rehabilitation and Sports

  • Physical Therapist
  • Clemson, SC
  • NPI 1740358324
  Medicare reassignment Care Compare group NPD
• Excel Rehabilitation and Sports

  • Physical Therapist
  • Greenville, SC
  • NPI 1952272379
  NPD

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1053929281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 FOREST LN",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296312621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 FOREST LN",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296312621",
            "telephone_number": "864-654-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLIAN",
        "first_name": "JACKSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Lane Johnson, M.S. CCC-SLP
• Daniel Travis Johnston, ATC
• Jennier Johnston
• Caitlin A Jordan, FNP
• Edmond R Jordan, MD
• Conor Patrick Klein, DPT
• Kendall Klumpp, PH.D.
• Mary Frances Knapp, DMD
• Christian Andreas Konhaeuser-Lopez
• Hilary Koster, NP-C

• Physical Therapist in Clemson, SC
• Providers in Clemson, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.