Kacy Mikala Kirk, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

22311 Issued in TN

Practice address

1803 N Jackson St
Tullahoma, TN 37388-2201

Phone

(931) 455-3400

NPI assigned

Feb 8, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centerstone of Tennessee, Inc.Group PAC ID 9739088113, 114 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Centerstone of Tennessee, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Nashville, TN
  • NPI 1396767430
  Medicare reassignment Care Compare group NPD
• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865
  Medicare reassignment NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Centerstone of Tennessee, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Manhattan, KS
  • NPI 1023900651
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1063950160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 ROBERTS CREEK CIR",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373553690",
            "telephone_number": "931-607-2531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 N JACKSON ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882201",
            "telephone_number": "931-455-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 Hillsboro Blvd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "TN",
            "postal_code": "373552599",
            "country_code": "US",
            "telephone_number": "931-954-5605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRK",
        "first_name": "KACY",
        "middle_name": "MIKALA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kacy.kirk@fastpacehealth.com",
            "affiliation": "N",
            "address_1": "1415 Hillsboro Blvd Ste 106",
            "city": "Manchester",
            "state": "TN",
            "country_code": "US",
            "postal_code": "373552599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Abby Keith, PMHNP-BC
• Elton Kerr, M.D.
• Ho Kim, M.D.
• Amanda King, OT
• Sarah Renee Kirby, MSSW
• Christine Lynn Kiser
• Joanna Koehler, RDN
• Joseph G Krick, M.D.
• Wanda Faye Krick, R.N.
• Sherry K Krickel, LPC-MHSP

• Family Nurse Practitioner in Tullahoma, TN
• Providers in Tullahoma, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.