Roger Stanley Kilbourn, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO177082 Issued in OR

Practice address

White Earth Indian Health Center
40520 County Highway 34
Ogema, MN 56569-9612

Phone

(218) 983-4300

Fax

(218) 983-6217

NPI assigned

Apr 4, 2006

Last updated

Sep 4, 2020By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Interoperability endpoints

• Direct secure messaging: rkilbourn834872@wm.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jicarilla IHS Pharmacy

  dba Dulce IHS Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Dulce, NM
  • NPI 1124220900
  NPD

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1740242841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40520 COUNTY HIGHWAY 34",
            "city": "OGEMA",
            "state": "MN",
            "postal_code": "565699612",
            "telephone_number": "218-983-4300",
            "fax_number": "218-983-6217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WHITE EARTH INDIAN HEALTH CENTER",
            "address_2": "40520 COUNTY HIGHWAY 34",
            "city": "OGEMA",
            "state": "MN",
            "postal_code": "565699612",
            "telephone_number": "218-983-4300",
            "fax_number": "218-983-6217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 4th St",
            "address_purpose": "LOCATION",
            "city": "LA Grande",
            "state": "OR",
            "postal_code": "97850",
            "country_code": "US",
            "telephone_number": "541-663-3138",
            "fax_number": "541-975-5120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 N Mundo",
            "address_purpose": "LOCATION",
            "city": "Dulce",
            "state": "NM",
            "postal_code": "875280187",
            "country_code": "US",
            "telephone_number": "575-759-3291",
            "fax_number": "575-759-3532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILBOURN",
        "first_name": "ROGER",
        "middle_name": "STANLEY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO177082",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101014954",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Ogema",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "White Earth Indian Health Center",
            "address_2": "40520 County Highway 34",
            "city": "OGEMA",
            "state": "MN",
            "country_code": "US",
            "postal_code": "565699612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Toby Joe Imler Jr., DDS
• Steven W Jensen, PT
• David Emanuel Johnson, MD
• Melissa Louise Keezer
• Catherine M Kempner, REGISTERED NURSE
• Austin Klapperich, PHARMD
• Renee Lafriniere, LPCC
• Michael J Laroque, MD
• Gregory Larson, MEDICAL TECHNOLOGIST
• Cody James Leff, PHARMD

• Family Medicine Physician in Ogema, MN
• Providers in Ogema, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.