Active NPI
David A. Killingbeck, PA-C
- Physician Assistant
- Clare, MI
National Provider Identifier
1780737130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601002451
- Practice address
- 703 N McEwan St
Clare, MI 48617-1440 - Phone
- (989) 386-5120
- Fax
- (989) 802-8880
- NPI assigned
- Jan 19, 2007
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601002451 | MI | Primary |
Addresses
Primary practice location
703 N McEwan St
Clare, MI 48617-1440
Mailing address
101 High St
Yale, MI 48097-2835
Phone (810) 387-9715
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)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780737130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 HIGH ST",
"city": "YALE",
"state": "MI",
"postal_code": "480972835",
"telephone_number": "810-387-9715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 N MCEWAN ST",
"city": "CLARE",
"state": "MI",
"postal_code": "486171440",
"telephone_number": "989-386-5120",
"fax_number": "989-802-8880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILLINGBECK",
"first_name": "DAVID",
"middle_name": "A.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601002451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clare, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.