Mark R. Killman, M.D. P.C.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

107716 Issued in MO

Legal business name

MARK R. KILLMAN, M.D. P.C.

Practice address

19550 E 39TH St S
Suite 415
Independence, MO 64057-2303

Phone

(816) 254-9595

Fax

(816) 836-3810

NPI assigned

Sep 6, 2007

Last updated

Sep 6, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark Ray Killman, M.D.NPI 1194778910

Title

Physician, President

Phone

(816) 254-9595

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, KS2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Ray Killman, M.D.

  • Rehabilitation Practitioner
  • Independence, MO
  • NPI 1194778910

  KS

  Medicare reassignment NPD Authorized official
• John A Gillen II, M.D.

  • Orthopaedic Surgery Physician
  • Grandview, MO
  • NPI 1881696136
  NPD (past)

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189036800000",
    "number": "1285828913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19550 E 39TH ST S",
            "address_2": "SUITE 415",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572303",
            "telephone_number": "816-254-9595",
            "fax_number": "816-836-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19550 E 39TH ST S",
            "address_2": "SUITE 415",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572303",
            "telephone_number": "816-254-9595",
            "fax_number": "816-836-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK R. KILLMAN, M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A",
        "authorized_official_last_name": "KILLMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PHYSICIAN, PRESIDENT",
        "authorized_official_telephone_number": "816-254-9595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "107716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Nicole Mansfield
• Manual Therapy Center, LLC
• Shahzaib I Maqbool, MBBS
• Marian Hope (Marian Hope Academy)
• Mark Dental, LLC
• Mark Smith, Professional Services, LLC
• Jeffrey Mark, D.D.S.
• Richard George Mark, DDS
• Sophia Markowsky
• Gregory Alan Markway, MD

• Physical Medicine & Rehabilitation Physician in Independence, MO
• Providers in Independence, MO by specialty
• Physical Medicine & Rehabilitation Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.