Individual provider Active NPI

John Thomas Killian, MD

  • Orthopaedic Surgery Physician
  • Pensacola, FL
National Provider Identifier
1821066390
Registry record updated Mar 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
ME143720 Issued in FL
Practice address
5153 N 9TH Ave
Pensacola, FL 32504-8785
Phone
(850) 416-1575
Fax
(850) 416-1302
NPI assigned
Mar 10, 2006
Last updated
Mar 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 9280 AL
Orthopaedic Surgery Physician 207X00000X ME143720 FL Primary

Addresses

Primary practice location

5153 N 9TH Ave
Pensacola, FL 32504-8785

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6014

Other practice location 1

36500 Emerald Coast Pkwy
Destin, FL 32541-4713
Phone (850) 416-1575

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200328000045 FL Practitioner - Orthopedic Surgery 4789626383

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9280ALMDOrthopaedic Surgery Physician
ME143720FLMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. Current Accepting new patients
Orthopaedic Specialists of Alabama, PC Orthopaedic Surgery PastSince Oct 12, 2001 Accepting new patients
Orthopaedic Specialists of Alabama PC Orthopaedic Surgery Past Accepting new patients

Locations

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

Interoperability endpoints

  • Direct secure messaging: john.killian@direct.baptistfirst.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1821066390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6014",
            "fax_number": "904-450-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5153 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048785",
            "telephone_number": "850-416-1575",
            "fax_number": "850-416-1302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36500 Emerald Coast Pkwy",
            "address_purpose": "LOCATION",
            "city": "Destin",
            "state": "FL",
            "postal_code": "325414713",
            "country_code": "US",
            "telephone_number": "850-416-1575",
            "fax_number": "850-278-3421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLIAN",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AL",
            "license": "9280",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME143720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.