Individual provider Active NPI

Melissa Michelle Killgore, P.T,

  • Physical Therapist
  • Shawnee, OK
National Provider Identifier
1194772699
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2089 Issued in OK
Practice address
3315 Kethley Rd
Shawnee, OK 74804-9638
Phone
(405) 273-5801
Fax
(405) 878-3814
NPI assigned
May 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2089 OK Primary

Addresses

Primary practice location

3315 Kethley Rd
Shawnee, OK 74804-9638

Mailing address

PO Box 849
Shawnee, OK 74802-0849
Phone (405) 273-5801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100108000781 OK Practitioner - Physical Therapist in Private Practice 8527109859 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.48 of 100Reported as group
Quality
81.18
Promoting interoperability
93
Improvement activities
40
Cost
72.93

Merit-based Incentive Payment System (MIPS)

Final score
85.96 of 100Reported as group
Quality
80.43
Promoting interoperability
100
Improvement activities
40
Cost
72.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care of Oklahoma, Inc. CurrentSince May 1, 2012 Accepting new patients
SSM Health Care of Oklahoma Inc CurrentSince May 1, 2012 Accepting new patients
SSM Health Care of Oklahoma, Inc Current Accepting new patients
Saints Medical Group, LLC CurrentSince Aug 1, 2020 Accepting new patients
Saints Medical Group, LLC CurrentSince Aug 1, 2020 Accepting new patients

Locations

7106 Solutions Ctr
Chicago, IL 60677

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

608 NW 9th St
Ste 1100
Oklahoma City, OK 73102
Phone (405) 231-3000

777 NW 63rd St
Fl 4
Oklahoma City, OK 73116
Phone (405) 231-3818

3315 Kethley Rd
Shawnee, OK 74804
Phone (405) 273-5801

Organizations & group practices 5

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": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1194772699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 849",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748020849",
            "telephone_number": "405-273-5801",
            "fax_number": "405-878-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 KETHLEY RD",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748049638",
            "telephone_number": "405-273-5801",
            "fax_number": "405-878-3814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLGORE",
        "first_name": "MELISSA",
        "middle_name": "MICHELLE",
        "credential": "P.T,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "2089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.