Individual provider Active NPI

Linda Kay Killough, RN

  • Registered Nurse First Assistant
  • Palm Beach Gardens, FL
National Provider Identifier
1205043957
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
858692 Issued in FL
Practice address
4060 Pga Blvd
Suite 204
Palm Beach Gardens, FL 33410-6574
Phone
(561) 776-7112
Fax
(561) 776-7113
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 858692 FL Primary

Addresses

Primary practice location

4060 Pga Blvd
Suite 204
Palm Beach Gardens, FL 33410-6574

Mailing address

3716 Whitehall Dr Apt 106
West Palm Beach, FL 33401-1060
Phone (561) 776-7112

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
858692FLMDRegistered Nurse First Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
ENT and Allergy Associates of Florida, LLC PastSince Aug 4, 2012 Accepting new patients
Harbour ENT Past Accepting new patients

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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205043957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 WHITEHALL DR APT 106",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334011060",
            "telephone_number": "561-776-7112",
            "fax_number": "561-776-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 PGA BLVD",
            "address_2": "SUITE 204",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334106574",
            "telephone_number": "561-776-7112",
            "fax_number": "561-776-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLOUGH",
        "first_name": "LINDA",
        "middle_name": "KAY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "FL",
            "license": "858692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.