JACK IRVIN KILLMAN PMHNP-BC
NPI 1124887534
Nurse Practitioner - Psychiatric/Mental Health in Bowling Green, KY
About Jack Irvin Killman Pmhnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACK IRVIN KILLMAN PMHNP-BC (NPI 1124887534) is an individual psychiatric/mental health provider in Bowling Green, Kentucky, licensed in Kentucky (4036621) and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jack Irvin Killman Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Jack Killman reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Bowling Green, KY 42103
- Reassigned Medicare billing, Kentucky enrollment
- 91 clinicians in this Medicare group
Montgomery, AL 36117
- Reassigned Medicare billing, Kentucky enrollment
- 18 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 42103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jack Killman's NPI number?
The NPI number for Jack Killman is 1124887534. It was assigned to this individual provider in the NPPES registry on March 18, 2024.
Where is Jack Killman located?
Jack Killman practices at 380 Suwannee Trail St, Bowling Green, KY 42103. The listed phone number is (270) 901-5000.
What is Jack Killman's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Jack Killman enrolled in Medicare?
Yes. Jack Killman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Jack Killman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jack Killman reassigns Medicare benefits to 2 organizations: Lifeskills, Inc. (Bowling Green, KY) and River Region Psychiatry Associates LLC (Montgomery, AL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jack Killman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jack Killman accept?
Health plans from Anthem Blue Cross and Blue Shield and Cigna Healthcare list Jack Killman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jack Killman was last updated on July 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jack Irvin Killman, PMHNP-BC · NPI 1124887534
Psychiatric/Mental Health physician in Bowling Green, Kentucky. Individual provider, active in the CMS NPPES registry since March 18, 2024.
## Identity
- **NPI:** 1124887534 (Entity type: Individual)
- **Enumerated:** March 18, 2024
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 4036621 (Kentucky)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 380 SUWANNEE TRAIL ST, Bowling Green, KY 42103-7956
- **Phone:** (270) 901-5000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Lifeskills, Inc. (NPI 1669401816, Bowling Green, KY); River Region Psychiatry Associates LLC (NPI 1386891497, Montgomery, AL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** July 22, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1124887534) · Data from the CMS NPPES public registry.