Kirbicort, Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

7G343A-C Issued in FL

Legal business name

KIRBICORT, INC.

Practice address

2901 Yule CT
Christmas, FL 32709-8717

Phone

(407) 568-6342

NPI assigned

Feb 6, 2006

Last updated

Mar 21, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael G Pruner, RN

Title

Administrator

Phone

(407) 971-8115

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332288000000",
    "number": "1073585808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 CURRYVILLE RD",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327669152",
            "telephone_number": "407-971-8115",
            "fax_number": "407-977-9458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 YULE CT",
            "city": "CHRISTMAS",
            "state": "FL",
            "postal_code": "327098717",
            "telephone_number": "407-568-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRBICORT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-06",
        "last_updated": "2012-03-21",
        "status": "A",
        "authorized_official_last_name": "PRUNER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "407-971-8115",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "7G343A-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "684718896",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Selwyn Barbee, RN
• Kelly Diane Rutherford
• Carlos Santos
• Scott D Bush LLC

• Adult Care Home Facility in Christmas, FL
• Providers in Christmas, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.