Philip Jake Killgore, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

205140 Issued in LA

Practice address

1 Medical Plaza PL
Minden, LA 71055-3330

Phone

(318) 377-2321

NPI assigned

Aug 17, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minden Anesthesia LLCGroup PAC ID 1355687757, 8 clinicians

Shreveport Sedation Associates, LLCGroup PAC ID 3173886736, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Minden Medical Center Hospital, Minden, LA, CCN 190144

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

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.

• Minden Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Minden, LA
  • NPI 1710456736

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Shreveport Sedation Associates LLC

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
  • NPI 1770083164

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Tandem Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
  • NPI 1356453583

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesia Dynamics LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073001012

  LA, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• CLHG - Minden, LLC

  • Rural Acute Care Hospital
  • Minden, LA
  • NPI 1891873337
  Care Compare affiliation

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1295280436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1547",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653021547",
            "telephone_number": "660-826-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PLAZA PL",
            "city": "MINDEN",
            "state": "LA",
            "postal_code": "710553330",
            "telephone_number": "318-377-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLGORE",
        "first_name": "PHILIP",
        "middle_name": "JAKE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-17",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "205140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Honey Jupiter
• Just Health
• Just Health
• Irene Kemp
• Mikel Key, DIRECTOR
• Rickey Don Killian, P.T.
• Cristal Chanel Kirby, M.D.
• Latonya Knowles
• Stephanie Knowles
• Laboratory Corporation of America Holdings

• Certified Registered Nurse Anesthetist in Minden, LA
• Providers in Minden, LA by specialty
• Certified Registered Nurse Anesthetist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; 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.