Active NPI
Samantha A. Kirk, PH.D.
- Psychologist
- Cranston, RI
National Provider Identifier
1003869876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS00884
- Practice address
- 84 Bartlett Ave
Cranston, RI 02905-1336 - Phone
- (401) 243-7044
- Fax
- (401) 842-0360
- NPI assigned
- May 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS00884 | RI | Primary |
Addresses
Primary practice location
84 Bartlett Ave
Cranston, RI 02905-1336
Mailing address
84 Bartlett Ave
Cranston, RI 02905-1336
Phone (401) 243-7044
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SK56341 | Medicaid | RI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 26, 2022 through Jan 26, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifespan Physician Group, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Brown Health Medical Group
- Emergency Medicine Physician
- Providence, RI
- NPI 1568325678
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367971200000",
"number": "1003869876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "84 BARTLETT AVE",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029051336",
"telephone_number": "401-243-7044",
"fax_number": "401-842-0360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "84 BARTLETT AVE",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029051336",
"telephone_number": "401-243-7044",
"fax_number": "401-842-0360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRK",
"first_name": "SAMANTHA",
"middle_name": "A.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-19",
"last_updated": "2013-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "RI",
"license": "PS00884",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SK56341",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cranston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.