Michael Austin Killingsworth, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2820 Issued in AR

Practice address

798 W Service Rd
West Memphis, AR 72301-1727

Phone

(870) 732-2066

NPI assigned

Jul 16, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Oscar Ramos, O.D.

  • Optometrist
  • West Memphis, AR
  • NPI 1861500175
  Medicare reassignment

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597536000000",
    "number": "1104434042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 SUMMITT ST APT 3",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381045370",
            "telephone_number": "479-964-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "798 W SERVICE RD",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723011727",
            "telephone_number": "870-732-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLINGSWORTH",
        "first_name": "MICHAEL",
        "middle_name": "AUSTIN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-16",
        "last_updated": "2020-08-16",
        "certification_date": "2020-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3595",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kids for the Future of Marion, Inc.
• Kids for the Future, Inc.
• Kids for the Future, Inc.
• Kidz Choice West Memphis PLLC
• Margaret C. Killgore, OTR/L
• Kindred Hearts LLC (Kindred Hearts of Arkansas)
• Caroline Myers Kitchens, PHARM.D.
• KMJ Transit LLC
• Kelli Kovach, RN
• Gary Allen Kovalsky, D.C.

• Optometrist in West Memphis, AR
• Providers in West Memphis, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.