Active NPI
Kerry Kilgore, RNFA
- Medical-Surgical Registered Nurse
- Lebanon, OR
National Provider Identifier
1285914333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical-Surgical Registered Nurse
- License
- 200241497RN
- Practice address
- 525 N Santiam Hwy
Lebanon, OR 97355-4363 - Phone
- (541) 258-2101
- NPI assigned
- Aug 22, 2011
- Last updated
- Jan 14, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | 200241497RN | OR | Primary |
Addresses
Primary practice location
525 N Santiam Hwy
Lebanon, OR 97355-4363
Mailing address
PO Box 1193
Corvallis, OR 97339-1193
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200241497RN | Other | OR | OREGON BOARD OF NURSING |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kkilgore4000@samhealth.direct-ci.com |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 200241497RN | OR | MD | Medical-Surgical Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610582400000",
"number": "1285914333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1193",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973391193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 N SANTIAM HWY",
"city": "LEBANON",
"state": "OR",
"postal_code": "973554363",
"telephone_number": "541-258-2101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILGORE",
"first_name": "KERRY",
"name_prefix": "Ms.",
"credential": "RNFA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-22",
"last_updated": "2021-01-14",
"certification_date": "2021-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": "OR",
"license": "200241497RN",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON BOARD OF NURSING",
"identifier": "200241497RN",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kkilgore4000@samhealth.direct-ci.com",
"affiliation": "N",
"address_1": "525 N Santiam Hwy",
"city": "Lebanon",
"state": "OR",
"country_code": "US",
"postal_code": "973554363",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Lebanon, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.