Active NPI
Earl Robert Kilgore Jr., PSY.D.
- Clinical Psychologist
- Des Moines, IA
National Provider Identifier
1144584483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 001043
- Practice address
- 1801 Hickman Rd
Des Moines, IA 50314-1505 - Phone
- (515) 282-2200
- NPI assigned
- Jul 2, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 001043 | IA | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 001043 | IA |
Addresses
Primary practice location
1801 Hickman Rd
Des Moines, IA 50314-1505
Mailing address
1801 Hickman Rd
Des Moines, IA 50314-1505
Phone (515) 282-2200
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369267200000",
"number": "1144584483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 HICKMAN RD",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503141505",
"telephone_number": "515-282-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 HICKMAN RD",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503141505",
"telephone_number": "515-282-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILGORE",
"first_name": "EARL",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-02",
"last_updated": "2013-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IA",
"license": "001043",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "IA",
"license": "001043",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.