Bradley James Killebrew, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6746 Issued in LA

Practice address

1116 S Purpera Ave
Gonzales, LA 70737-4361

Phone

(225) 647-3577

NPI assigned

May 25, 2017

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

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jeansonnespillersddsllc

  • General Practice Dentistry
  • Baton Rouge, LA
  • NPI 1306317516
  NPD (past)
• Spillover, LLC

  • Dentist
  • Gonzales, LA
  • NPI 1780074054
  NPD (past)

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495670400000",
    "number": "1902334600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11439 SPRING CREEK DR",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031919",
            "telephone_number": "985-981-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 S PURPERA AVE",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707374361",
            "telephone_number": "225-647-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLEBREW",
        "first_name": "BRADLEY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-25",
        "last_updated": "2017-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "6746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denson Chanse Kendrick, DC
• Sanielle S Kennedy
• Sharon B Kernan, RN
• Deidre G Kibbe, LCSW
• Darla Lynn Kiffe, WHNP-BC
• William Bradley Kimbrough III, M.D.
• Christian Kirk
• Amy Lynette Kisner, MD
• Scott Clayton Kogler
• Komprehensive Transportation

• General Practice Dentistry in Gonzales, LA
• Providers in Gonzales, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.