Jordan Ryan Kilgore, RN, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

34441 Issued in TN

Practice address

870 Boston Town Rd
Dunlap, TN 37327-4536

Phone

(423) 243-4812

NPI assigned

Aug 9, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, KY2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Chattanooga Medical College, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Longevity Clinical LTC Associates of Tennessee, PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Red Boiling Springs, TN
  • NPI 1326878299

  Gerontology

  Medicare reassignment NPD
• Longevity Clinical LTC Associates of Kentucky, PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Louisville, KY
  • NPI 1932935798

  Gerontology

  Medicare reassignment NPD

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1962185686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 BOSTON TOWN RD",
            "city": "DUNLAP",
            "state": "TN",
            "postal_code": "373274536",
            "telephone_number": "423-243-4812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 BOSTON TOWN RD",
            "city": "DUNLAP",
            "state": "TN",
            "postal_code": "373274536",
            "telephone_number": "423-243-4812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILGORE",
        "first_name": "JORDAN",
        "middle_name": "RYAN",
        "credential": "RN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-09",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "231456",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TN",
            "license": "34441",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "34441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aundrea Johnson, COTA
• Charlotte Boston Johnson, RN
• Kasha Jones, COTA/L
• Destiny Kassner, MS, OTR/L
• Kenneth W. Nix, O.D.
• Karen B King, RNC
• Kingbird Emergency Physicians LLC
• James Andrew Layman, M.D.
• Lincare Inc.
• Tanner W Linz, DPT

• Acute Care Nurse Practitioner in Dunlap, TN
• Providers in Dunlap, TN by specialty
• Acute Care Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.