NPIMap

Individual provider Active NPI

David J Killeen, D.O.

  • Pulmonary Disease Physician
  • Salem, VA
National Provider Identifier
1700821436
Registry record updated Jun 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
0102201703 Issued in VA
Practice address
1802 Braeburn Dr
Salem, VA 24153-7357
Phone
(540) 772-3540
Fax
(540) 776-2023
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 0102201703 VA Primary

Addresses

Primary practice location

1802 Braeburn Dr
Salem, VA 24153-7357

Mailing address

PO Box 403901
Atlanta, GA 30384-3901
Phone (816) 701-4101

Other identifiers 1

IdentifierTypeStateIssuer
1700821436MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050426000331 VA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 1759320237 Reassigns benefits to 1 organization
I20230816003157 WV Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 1759320237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
West Virginia School of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Practice addresses (Care Compare)

1900 Electric Rd
Salem, VA 24153-7474
Phone (561) 997-0821

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3964WVMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Jul 3, 2023 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Jul 3, 2023 Accepting new patients
Intensive Care Consortium Inc CurrentSince Jan 1, 2017 Accepting new patients
Neighborhood Health Past Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

1900 Electric Rd
Salem, VA 24153
Phone (540) 772-3400

3100 Maccorkle Ave SE
Ste 205
Charleston, WV 25304
Phone (304) 388-2303

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

1401 Hospital Dr
Ste 304
Hurricane, WV 25526
Phone (304) 351-1567

Interoperability endpoints

  • Direct secure messaging: david.killeen@hca6.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244592000000",
    "number": "1700821436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 403901",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303843901",
            "telephone_number": "816-701-4101",
            "fax_number": "866-298-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 BRAEBURN DR",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537357",
            "telephone_number": "540-772-3540",
            "fax_number": "540-776-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLEEN",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2009-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "VA",
            "license": "0102201703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700821436",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

Verify at the official NPI Registry.