Individual provider Active NPI

Brian Lamar Killian, DPM

  • Podiatrist
  • Matthews, NC
National Provider Identifier
1417942137
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
367 Issued in NC
Practice address
Matthews Foot Care
526 West John Street
Matthews, NC 28105-5353
Phone
(704) 847-9788
Fax
(704) 849-2928
NPI assigned
Sep 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 367 NC Primary

Addresses

Primary practice location

Matthews Foot Care
526 West John Street
Matthews, NC 28105-5353

Mailing address

M and L Podiatry
526 West John Street
Matthews, NC 28105-5353
Phone (704) 847-9788

Other identifiers 2

IdentifierTypeStateIssuer
890804CMedicaidNC
367OtherNCSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20090608000593 NC Practitioner - Podiatry 6305996612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

323 N Broome St
Waxhaw, NC 28173-7483
Phone (704) 243-7844

Merit-based Incentive Payment System (MIPS)

Final score
88.95 of 100Reported as group
Promoting interoperability
87
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions30
Removal of nail tissue1473
Removal or shaving of skin growth237

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
367NCMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC Podiatrist CurrentSince Aug 1, 2021 Accepting new patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC Podiatrist CurrentSince Aug 1, 2021 Accepting new patients

Locations

130 Lake Concord Rd NE
Ste B
Concord, NC 28025
Phone (704) 786-4482

626 Clark Dr
Lincolnton, NC 28092
Phone (704) 732-4361

534 W John St
Ste 100
Matthews, NC 28105
Phone (704) 847-9788

1418 E Millbrook Rd
Raleigh, NC 27609
Phone (919) 850-9111

323 N Broome St
Waxhaw, NC 28173
Phone (704) 243-7844

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": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1417942137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "M AND L PODIATRY",
            "address_2": "526 WEST JOHN STREET",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055353",
            "telephone_number": "704-847-9788",
            "fax_number": "704-849-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MATTHEWS FOOT CARE",
            "address_2": "526 WEST JOHN STREET",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055353",
            "telephone_number": "704-847-9788",
            "fax_number": "704-849-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLIAN",
        "first_name": "BRIAN",
        "middle_name": "LAMAR",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NC",
            "license": "367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890804C",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "367",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.