Larry R Killen, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

020528 Issued in TN

Practice address

2370 N Ocoee St
Cleveland, TN 37311-3850

Phone

(423) 479-6214

Fax

(423) 614-4405

NPI assigned

Jul 7, 2005

Last updated

Oct 13, 2010By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Cleveland Radiology Associates, PC

  • Diagnostic Radiology Physician
  • Cleveland, TN
  • NPI 1174552202
  NPD (past)

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1740287507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3990",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373203990",
            "telephone_number": "423-479-6214",
            "fax_number": "423-614-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2370 N OCOEE ST",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113850",
            "telephone_number": "423-479-6214",
            "fax_number": "423-614-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLEN",
        "first_name": "LARRY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "020528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3051907",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Ester Kibwage, NP-C
• Kidney Center of Cleveland, LLC
• Kidney Center of Cleveland, LLC
• Kids Dental Center, GP
• Jennifer Aubrey Kilby, FNP-C
• Janella Kristen Killingsworth, DNP, FNP-C, RN, CWCN
• Collin Sidney Killough, MS
• Brandi Joann Kilpatrick
• Shila Kimpson, NP
• Desiree Deeanna Kinard, PA

• Diagnostic Radiology Physician in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Diagnostic Radiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; 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.