Individual provider Active NPI

Jeffrey C Kilroy, NP

  • Family Nurse Practitioner
  • Newburyport, MA
National Provider Identifier
1346575289
Registry record updated Jun 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN275429 Issued in MA
Practice address
21 Highland Ave
Suite 2
Newburyport, MA 01950-3872
Phone
(978) 463-7770
Fax
(978) 462-0220
NPI assigned
Oct 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN275429 MA Primary

Addresses

Primary practice location

21 Highland Ave
Suite 2
Newburyport, MA 01950-3872

Mailing address

21 Highland Ave
Suite 2
Newburyport, MA 01950-3872
Phone (978) 463-7770

Other identifiers 1

IdentifierTypeStateIssuer
110072703AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince May 1, 2015 Accepting new patients
Harborlight Family Medicine, PC CurrentSince May 22, 2013 Accepting new patients

Locations

100 Cummings Ctr
Ste 232C
Beverly, MA 01915
Phone (267) 879-1789

900 Cummings Ctr
Ste 126V
Beverly, MA 01915
Phone (978) 279-0800

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1255046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403827200000",
    "number": "1346575289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 HIGHLAND AVE",
            "address_2": "SUITE 2",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019503872",
            "telephone_number": "978-463-7770",
            "fax_number": "978-462-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 HIGHLAND AVE",
            "address_2": "SUITE 2",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019503872",
            "telephone_number": "978-463-7770",
            "fax_number": "978-462-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILROY",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-09",
        "last_updated": "2014-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN275429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110072703A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburyport, MA

Sources for this page

Verify at the official NPI Registry.