Active NPI
Kylene Mackillop, MD
- Student in an Organized Health Care Education/Training Program
- Augusta, ME
National Provider Identifier
1477904746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- EC161077
- Practice address
- 15 E Chestnut St
Augusta, ME 04330-5736 - Phone
- (207) 626-1561
- Fax
- (207) 626-1849
- NPI assigned
- Jun 28, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | EC161077 | ME | Primary |
Addresses
Primary practice location
15 E Chestnut St
Augusta, ME 04330-5736
Mailing address
15 E Chestnut St
Augusta, ME 04330-5736
Phone (207) 626-1561
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: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467072000000",
"number": "1477904746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 E CHESTNUT ST",
"city": "AUGUSTA",
"state": "ME",
"postal_code": "043305736",
"telephone_number": "207-626-1561",
"fax_number": "207-626-1849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 E CHESTNUT ST",
"city": "AUGUSTA",
"state": "ME",
"postal_code": "043305736",
"telephone_number": "207-626-1561",
"fax_number": "207-626-1849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKILLOP",
"first_name": "KYLENE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-28",
"last_updated": "2016-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "ME",
"license": "EC161077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Augusta, ME
- Rebecca Alyson Lynch, MOT OTR/L
- Joe Maalouf, M.D.
- Ashley Andrews Macdearmid, PA, ATC
- Machias River Family Psychiatry LLC
- Machias River Family Psychiatryllc
- Nicole Summers Macmillan, MS, OTR/L
- Peter A Macmullan, PSY.D.
- Vanessa Lynn Macoy, LCSW
- Melissa Ann Macphee, LCSW
- Maxwell Alexander Madden, LMSW, LCDC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.