Individual provider Active NPI

Mary Killmeyer, D.M.F.T, L.M.F.T.

  • Marriage & Family Therapist
  • Plantation, FL
National Provider Identifier
1255708608
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT2678 Issued in FL
Practice address
1830 N Pine Island Rd
Plantation, FL 33322-5202
Phone
(954) 609-8175
Fax
(954) 337-3722
NPI assigned
Sep 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT2678 FL Primary

Addresses

Primary practice location

1830 N Pine Island Rd
Plantation, FL 33322-5202

Mailing address

1650 NW 100TH Way
Plantation, FL 33322-6516
Phone (954) 609-8175

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

State licenses

LicenseStateTypeSpecialty
MT2678FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Therapy Providers, PA PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 1

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": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1255708608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 NW 100TH WAY",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333226516",
            "telephone_number": "954-609-8175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 N PINE ISLAND RD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333225202",
            "telephone_number": "954-609-8175",
            "fax_number": "954-337-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLMEYER",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "D.M.F.T, L.M.F.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-01",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT2678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; 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.