Active NPI
Eric James Kirwan, LISW
- Social Worker
- Tyndall Afb, FL
National Provider Identifier
1043499742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 102100000X
- Practice address
- 325 MDG, 340 Magnolia Circle
Tyndall Afb, FL 32403 - Phone
- (850) 283-7511
- NPI assigned
- Oct 30, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 102100000X | CA | Primary |
Addresses
Primary practice location
325 MDG, 340 Magnolia Circle
Tyndall Afb, FL 32403
Mailing address
4102 Pinion Dr 10 MDG
Usaf, CO 80840
Phone (719) 333-5177
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102100000X | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566259200000",
"number": "1043499742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4102 PINION DR 10 MDG",
"city": "USAF",
"state": "CO",
"postal_code": "80840",
"telephone_number": "719-333-5177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 MDG, 340 MAGNOLIA CIRCLE",
"city": "TYNDALL AFB",
"state": "FL",
"postal_code": "32403",
"telephone_number": "850-283-7511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRWAN",
"first_name": "ERIC",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-30",
"last_updated": "2019-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "102100000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyndall Afb, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.