Active NPI
J William Kirk, IDC
- Independent Duty Corpsman
- San Diego, CA
National Provider Identifier
1043606205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Independent Duty Corpsman
- Practice address
- 34101 Farenholt Ave
San Diego, CA 92134-7000 - Phone
- (858) 539-5507
- NPI assigned
- Apr 14, 2015
- 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 |
|---|---|---|---|---|
| Independent Duty Corpsman | 1710I1002X | Primary |
Addresses
Primary practice location
34101 Farenholt Ave
San Diego, CA 92134-7000
Mailing address
Unit 100331 Box 1
Fpo, AE 09513-3100
Phone (757) 443-8798
Other practice location 1
2989 E Arow St
Yuma, AZ 85365
Phone (928) 269-2700
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528675200000",
"number": "1043606205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "UNIT 100331 BOX 1",
"city": "FPO",
"state": "AE",
"postal_code": "095133100",
"telephone_number": "757-443-8798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34101 FARENHOLT AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921347000",
"telephone_number": "858-539-5507"
}
],
"practiceLocations": [
{
"address_1": "2989 E Arow St",
"address_purpose": "LOCATION",
"city": "Yuma",
"state": "AZ",
"postal_code": "85365",
"country_code": "US",
"telephone_number": "928-269-2700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIRK",
"first_name": "J",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"credential": "IDC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-14",
"last_updated": "2018-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "1710I1002X",
"taxonomy_group": "",
"desc": "Military Health Care Provider, Independent Duty Corpsman",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.