Individual provider Active NPI

Tina L Killmer

  • Computed Tomography Radiologic Technologist
  • Lebanon, PA
National Provider Identifier
1336396183
Registry record updated Aug 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Computed Tomography Radiologic TechnologistTaxonomy code 2471C3401X
License
385377 Issued in PA
Practice address
1700 S Lincoln Ave
Lebanon, PA 17042-7529
Phone
(717) 272-6621
NPI assigned
Aug 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Radiologic Technologist 247100000X 385377 PA
Computed Tomography Radiologic Technologist 2471C3401X 385377 PA Primary
Magnetic Resonance Imaging Radiologic Technologist 2471M1202X 385377 PA

Addresses

Primary practice location

1700 S Lincoln Ave
Lebanon, PA 17042-7529

Mailing address

522 Candlewyck Rd
Lancaster, PA 17601-2859
Phone (717) 666-5555

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
385377PAMDMagnetic Resonance Imaging Radiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1219449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219449600000",
    "number": "1336396183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 CANDLEWYCK RD",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012859",
            "telephone_number": "717-666-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S LINCOLN AVE",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427529",
            "telephone_number": "717-272-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLMER",
        "first_name": "TINA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-23",
        "last_updated": "2008-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "PA",
            "license": "385377",
            "primary": false
        },
        {
            "code": "2471C3401X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Computed Tomography",
            "state": "PA",
            "license": "385377",
            "primary": true
        },
        {
            "code": "2471M1202X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": "PA",
            "license": "385377",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2008; 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.