Larry H Killebrew (NPI# 1265514301, PAC ID# 5193879195) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1265514301 |
| PAC ID by PECOS | 5193879195 |
| Professional Enrollment ID | I20090810000544 |
| Full Name | Larry H Killebrew |
| Organization Legal Name | APP OF MISSISSIPPI ED LLC |
| Address |
350 Crossgates Blvd Brandon MS 39042-2601 |
| Phone Number | 6018252811 |
| Gender | M |
| Medical School | UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE |
| Graduation Year | 1978 |
| Primary Specialty | GENERAL SURGERY |
| Secondary Specialties | EMERGENCY MEDICINE |
| Group Practice PAC ID | 3971865858 |
| Number of Group Practice Members | 56 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250123 | GARDEN PARK MEDICAL CENTER |
| 250007 | MERIT HEALTH BILOXI |
| Address | Phone | Organization |
|---|---|---|
| 350 Crossgates Blvd, Brandon, MS 39042-2601 | 6018252811 | APP OF MISSISSIPPI ED LLC |
| 15190 Community Rd, Suite 250, Gulfport, MS 39503-3483 | 2285390489 | GARDEN PARK PHYSICIAN GROUP-SPECIALTY CARE LLC |
| 15200 Community Rd, Gulfport, MS 39503-3085 | 2285757000 | KEYSTONE MEDICAL SERVICES OF GULFPORT INC |
| 15200 Community Rd, Gulfport, MS 39503-3085 | GARDEN PARK PHYSICIAN GROUP-SPECIALTY CARE LLC | |
| 1850 Chadwick Dr, Jackson, MS 39204-3404 | 6013761000 | APP OF MISSISSIPPI ED LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | APP OF MISSISSIPPI ED LLC |
| Physicians | 39 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James H Carr | Emergency Medicine | App of Mississippi Ed LLC | 1850 Chadwick Dr, Jackson, MS 39204-3404 |
| Jason R Patten | Emergency Medicine | App of Mississippi Ed LLC | 1850 Chadwick Dr, Jackson, MS 39204-3404 |
| Eric J Zoog | Emergency Medicine | App of Mississippi Ed LLC | 54 Sergeant Prentiss Dr, Merit Health Natchez, Natchez, MS 39120-4726 |
| David Atushi Dean | Family Medicine | App of Mississippi Ed LLC | 1850 Chadwick Dr, Jackson, MS 39204-3404 |
| Elizabeth Mccord | Nurse Practitioner | App of Mississippi Ed LLC | 350 Crossgates Blvd, Brandon, MS 39042-2601 |
| Claire M Lakes | Nurse Practitioner | App of Mississippi Ed LLC | 150 Reynoir St, Biloxi, MS 39530-4130 |
| Marla Sutherland | Nurse Practitioner | App of Mississippi Ed LLC | 161 River Oaks Dr, Canton, MS 39046-5375 |
| Arthur E Wood Iv | Family Medicine | App of Mississippi Ed LLC | 2100 Hwy 61 N, Merit Health River Region, Vicksburg, MS 39183-8211 |
| Richard Miles | Emergency Medicine | App of Mississippi Ed LLC | 1850 Chadwick Dr, Jackson, MS 39204-3404 |
| George M Loukatos | Emergency Medicine | App of Mississippi Ed LLC | 350 Crossgates Blvd, Brandon, MS 39042-2601 |
| Street Address |
350 CROSSGATES BLVD |
| City | BRANDON |
| State | MS |
| Zip | 39042-2601 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Constantine P Zouboukos | Anesthesiology | Anesthesia Consultants Pa | 350 Crossgates Blvd, Brandon, MS 39042-2601 |
| David L Smith | Infectious Disease | Flowood River Oaks Hma Medical Group, LLC | 350 Crossgates Blvd, Brandon, MS 39042-2601 |
| Mollie Slaughter Harrell | Certified Registered Nurse Anesthetist (crna) | Anesthesia Consultants Pa | 350 Crossgates Blvd, Brandon, MS 39042-2601 |
| Joshua Williams | Internal Medicine | Mississippi Hma Hospitalists LLC | 350 Crossgates Blvd, Brandon, MS 39042-2601 |
| Elizabeth Mccord | Nurse Practitioner | App of Mississippi Ed LLC | 350 Crossgates Blvd, Brandon, MS 39042-2601 |
| Lee E Herring | Anesthesiology | Anesthesia Consultants Pa | 350 Crossgates Blvd, Brandon, MS 39042-2601 |
| Russell Wardlaw | Certified Registered Nurse Anesthetist (crna) | Anesthesia Consultants Pa | 350 Crossgates Blvd, Brandon, MS 39042-2601 |
| Jonathan Paul Bagley | Anesthesiology | Anesthesia Consultants Pa | 350 Crossgates Blvd, Brandon, MS 39042-2601 |
| Issac Perkins | Internal Medicine | Mississippi Hma Hospitalists LLC | 350 Crossgates Blvd, Brandon, MS 39042-2601 |
| Donald S Murray | Anesthesiology | Anesthesia Consultants Pa | 350 Crossgates Blvd, Brandon, MS 39042-2601 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lawrence E Tamburino | Podiatry | 103 Service Dr, Brandon, MS 39042-2401 | |
| Meseret Teferra | Internal Medicine | Family Health Care Clinic Inc | 1551 W Government St, Brandon, MS 39042-2408 |
| Arbie B Hinton | Family Medicine | Family Health Care Clinic Inc | 1551 W Government St, Brandon, MS 39042-2408 |
| Esquanickia Fletcher | Nurse Practitioner | Family Health Care Clinic Inc | 1551 W Government St, Brandon, MS 39042-2408 |
| Darryl Wheat | Clinical Social Worker | 1700 W Government St, Bldg A Suite G, Brandon, MS 39042-2420 | |
| Mylissa Hodges | Occupational Therapy | Sentry Rehab LLC | 6100 Old Brandon Rd, Brandon, MS 39042-2543 |
| Twanda Vershun Longino | Physical Therapy | Sentry Rehab LLC | 6100 Old Brandon Rd, Brandon, MS 39042-2543 |
| Kristy L Taylor | Qualified Speech Language Pathologist | Sentry Rehab LLC | 6100 Old Brandon Rd, Brandon, MS 39042-2543 |
| Thomas B Smith | Certified Registered Nurse Anesthetist (crna) | Anesthesia Consultants Pa | 350 Crossgates Blvd, Brandon, MS 39042-2601 |
| Almois Ali Mohamad | Cardiovascular Disease (cardiology) | River Oaks Management Company LLC | 350 Crossgates Blvd, Brandon, MS 39042-2601 |
| Find all physicians in zip 39042 | |||
| City | BRANDON |
| Zip Code | 39042 |
| Specialty | GENERAL SURGERY |
| City + Specialty | BRANDON + GENERAL SURGERY |
Please comment or provide details below to improve the information on Larry H Killebrew.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.