Douglas V McKillip, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

T02167 Issued in MO

Practice address

101 E. Tenth St.
Suite a
Caruthersville, MO 63830

Phone

(573) 333-1860

Fax

(573) 333-0099

NPI assigned

Feb 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

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, 1970

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

T M Swinger and D V McKillip, PTRGroup PAC ID 1052397882, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• T M Swinger & D V McKillip, PTR

  • Optometrist
  • Caruthersville, MO
  • NPI 1831387372
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1568597755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1137",
            "city": "CARUTHERSVILLE",
            "state": "MO",
            "postal_code": "638301137",
            "telephone_number": "573-333-1860",
            "fax_number": "573-333-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E. TENTH ST.",
            "address_2": "SUITE A",
            "city": "CARUTHERSVILLE",
            "state": "MO",
            "postal_code": "63830",
            "telephone_number": "573-333-1860",
            "fax_number": "573-333-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKILLIP",
        "first_name": "DOUGLAS",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310150404",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BNDD",
            "identifier": "4740912",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Britley Martin
• Kaylee May
• Terrance McClellan
• Susan McCollum
• Rachel R McGee
• Nadia McKinney
• Dax Owen Melugin
• Barbara Ward Merideth, RN, CS, FNP
• Audrina Mims
• Missouri Delta Medical Center

• Optometrist in Caruthersville, MO
• Providers in Caruthersville, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.