Individual provider Active NPI

Philip R. Kilmer, M.D.

  • Emergency Medicine Physician
  • Gregory, SD
National Provider Identifier
1891748299
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
8334 Issued in SD
Practice address
110 S Logan Ave
Gregory, SD 57533-1614
Phone
(605) 835-9611
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 8334 SD Primary

Addresses

Primary practice location

110 S Logan Ave
Gregory, SD 57533-1614

Mailing address

11332 Avery Rd
Palm Beach Gardens, FL 33410-3402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20120423000218 SD Practitioner - Emergency Medicine 8426098724 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, shared by 52 NPIs, 957 clinicians

Practice addresses (Care Compare)

405 Whittecar Ave
Gregory, SD 57533-1340
Phone (605) 835-9611

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8334SDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wagner Community Memorial Hospital Current Accepting new patients
Avera McKennan CurrentSince Apr 1, 2019 Accepting new patients
Avera McKennan CurrentSince Apr 1, 2019 Accepting new patients
Avera McKennan Current Accepting new patients
Wagner Community Memorial Hospital CurrentSince Jul 3, 2017 Accepting new patients
Avera McKennan Current Accepting new patients
Wagner Community Memorial Hospital CurrentSince Jul 3, 2017 Accepting new patients
Martin Memorial Medical Center Inc Past Accepting new patients

Locations

110 S Logan Ave
Gregory, SD 57533
Phone (605) 655-1220

401 9th Ave NW
Watertown, SD 57201
Phone (605) 886-9317

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1891748299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11332 AVERY RD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S LOGAN AVE",
            "city": "GREGORY",
            "state": "SD",
            "postal_code": "575331614",
            "telephone_number": "605-835-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILMER",
        "first_name": "PHILIP",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SD",
            "license": "8334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gregory, SD

Sources for this page

Verify at the official NPI Registry.