Individual provider Active NPI

William Tommy Kilgore, M.D.

  • Specialist
  • Wytheville, VA
National Provider Identifier
1164426672
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101035671 Issued in VA
Practice address
1785 W Lee Hwy
Wytheville, VA 24382-1437
Phone
(276) 228-3355
Fax
(276) 228-6665
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0101035671 VA Primary

Addresses

Primary practice location

1785 W Lee Hwy
Wytheville, VA 24382-1437

Mailing address

PO Box 652
Wytheville, VA 24382-0652
Phone (276) 228-3355

Other identifiers 1

IdentifierTypeStateIssuer
010027306MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20100713000108 VA Practitioner - Obstetrics/Gynecology 4284766106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Virginia School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Norton Community Physician Services LLCGroup PAC ID 1557431665, 29 clinicians

Practice addresses (Care Compare)

102 15TH St NW
Suite 301
Norton, VA 24273-1627
Phone (276) 679-1623

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101035671VAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Community Physician Services LLC CurrentSince Aug 10, 2020 Accepting new patients
Norton Community Physician Services LLC CurrentSince Aug 10, 2020 Accepting new patients

Locations

100 15th St NW
#307
Norton, VA 24273
Phone (276) 439-1140

98 15th St NW
Ste 208
Norton, VA 24273
Phone (276) 679-7600

102 15th St NW
Ste 301
Norton, VA 24273
Phone (276) 439-1470

Interoperability endpoints

  • Direct secure messaging: kilgore@gfpw.gwaydirect.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1164426672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 652",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243820652",
            "telephone_number": "276-228-3355",
            "fax_number": "276-228-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 W LEE HWY",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243821437",
            "telephone_number": "276-228-3355",
            "fax_number": "276-228-6665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILGORE",
        "first_name": "WILLIAM",
        "middle_name": "TOMMY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101035671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010027306",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wytheville, VA

Sources for this page

Verify at the official NPI Registry.