Harold Kilgore

Primary specialty

Child Mental Illness Respite CareTaxonomy code 385HR2055X

License

7470789 Issued in AZ

Practice address

3734 E Longhorn St
Queen Creek, AZ 85140-4303

Phone

(602) 321-4154

NPI assigned

Jun 18, 2019

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

Other identifiers 1

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.

• The Devereux Foundation

  • Adolescent and Children Mental Health Clinic/Center
  • Phoenix, AZ
  • NPI 1306939368
  NPD (past)

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1972163293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3734 E LONGHORN ST",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851404303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3734 E LONGHORN ST",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851404303",
            "telephone_number": "602-321-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILGORE",
        "first_name": "HAROLD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "AZ",
            "license": "7470789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ DEPT OF HEALTH SERVICES",
            "identifier": "7470789",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany A Khan, RPH
• Silas Mwesigwa Kibazo, PHARM.D
• Kids Grins-Queen Creek
• Martha Kay Kieffer, RN, BSN, MS
• Adrienne Kilbride, RBT
• Dae Woong Kim
• Kindred Midwifery and Wellness LLC
• Mercy Kinyanjui
• Kirk T Reed O D P C
• Kelly Lynne Kiser, NNP

• Child Mental Illness Respite Care in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Child Mental Illness Respite Care in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.