Barry Joseph Kilbourne, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

129150 Issued in NY

Practice address

309 County Route 47
Suite 1
Saranac Lake, NY 12983-5405

Phone

(518) 891-2688

Fax

(518) 891-4120

NPI assigned

Jul 29, 2005

Last updated

May 14, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1619977675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 COUNTY ROUTE 47",
            "address_2": "SUITE 1",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129835405",
            "telephone_number": "518-891-2688",
            "fax_number": "518-891-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 COUNTY ROUTE 47",
            "address_2": "SUITE 1",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129835405",
            "telephone_number": "518-891-2688",
            "fax_number": "518-891-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILBOURNE",
        "first_name": "BARRY",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "129150",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "129150",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "50E101",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP SELECT",
            "identifier": "109016",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "1619977675",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "50E101",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF NENY",
            "identifier": "000401212001",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00459467",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI FHP",
            "identifier": "P00000040484",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "DD2645",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Ayrton Johnson, MD
• Marc A Johnson, LCSW
• Andrea Johnston, LCSW-R
• Mark E Keating, MA LMHC
• Kathryn A Keniston
• Kerry King
• Lila King
• Yasmine Elisabeth King, FNP
• Samantha M Kingrey, LMHC
• Waguih S Kirollos, MD

• Internal Medicine Physician in Saranac Lake, NY
• Providers in Saranac Lake, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.