Michael Don Killough, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2528 Issued in AR

Practice address

1801 Red Wolf Blvd
Suite 101
Jonesboro, AR 72401-5450

Phone

(870) 910-5493

Fax

(870) 336-1775

NPI assigned

Sep 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Michael D. Killough, O.D. P.a.

  • Optometrist
  • Jonesboro, AR
  • NPI 1922238161
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441324800000",
    "number": "1306942503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 RED WOLF BLVD",
            "address_2": "SUITE 101",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015450",
            "telephone_number": "870-910-5493",
            "fax_number": "870-336-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 RED WOLF BLVD",
            "address_2": "SUITE 101",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015450",
            "telephone_number": "870-910-5493",
            "fax_number": "870-336-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLOUGH",
        "first_name": "MICHAEL",
        "middle_name": "DON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2015-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABCBS",
            "identifier": "49893",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.