Active NPI
James Killingbeck
- Pharmacotherapy Pharmacist
- Benton Harbor, MI
National Provider Identifier
1578974739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 5302023062
- Practice address
- 1920 Pipestone Rd
Benton Harbor, MI 49022-2315 - Phone
- (269) 934-6733
- Fax
- (269) 934-6765
- NPI assigned
- May 9, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 5302023062 | MI | Primary |
Addresses
Primary practice location
1920 Pipestone Rd
Benton Harbor, MI 49022-2315
Mailing address
1920 Pipestone Rd
Benton Harbor, MI 49022-2315
Phone (269) 934-6733
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2329616 | Medicaid | MI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302023062 | MI | MD | Pharmacotherapy Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meijer Inc | Past | Accepting new patients |
Organizations & group practices 1
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": "1399593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399593600000",
"number": "1578974739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1920 PIPESTONE RD",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490222315",
"telephone_number": "269-934-6733",
"fax_number": "269-934-6765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1920 PIPESTONE RD",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490222315",
"telephone_number": "269-934-6733",
"fax_number": "269-934-6765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILLINGBECK",
"first_name": "JAMES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-09",
"last_updated": "2014-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "MI",
"license": "5302023062",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2329616",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Benton Harbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.