Don Cleveland Kilcrease Jr.

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN081457 Issued in GA

Practice address

180 Water Oak Dr
Cedartown, GA 30125-2095

Phone

(770) 748-0030

Fax

(770) 749-4418

NPI assigned

Nov 24, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Highland Rivers CSB

  • Community/Behavioral Health Agency
  • Cedartown, GA
  • NPI 1689737033
  NPD (past)

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1831563162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 WATER OAK DR",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301252095",
            "telephone_number": "770-748-0030",
            "fax_number": "770-749-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 WATER OAK DR",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301252095",
            "telephone_number": "770-748-0030",
            "fax_number": "770-749-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILCREASE",
        "first_name": "DON",
        "middle_name": "CLEVELAND",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-24",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN081457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan Jones
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• Lorraine Louise Kennedy
• Sophia Kirchhoff, DO
• Mandy Leann Kisor, FNP-C
• Pamela Anne Kramer, CTRS
• Laura Krick, RBT
• Paula Lange

• Licensed Practical Nurse in Cedartown, GA
• Providers in Cedartown, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; 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.