Justin Kirkpatrick, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

203897 Issued in GA

Practice address

1107 Memorial Dr Ste 200
Dalton, GA 30720-8662

Phone

(706) 226-9355

Fax

(706) 226-9380

NPI assigned

May 28, 2014

Last updated

Feb 10, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  Nurse Practitioner, TN

  Medicare reassignment NPD
• Dalton Cardiology, P.C.

  • Cardiovascular Disease Physician
  • Dalton, GA
  • NPI 1669491619
  NPD (past)
• Hamilton Medical Center, Inc.

  • General Acute Care Hospital
  • Dalton, GA
  • NPI 1528056066
  NPD (past)
• Paragon Medical Associates

  • Family Medicine Physician
  • Dalton, GA
  • NPI 1720032212
  NPD (past)

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1083026892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1587",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307221587",
            "telephone_number": "706-529-7440",
            "fax_number": "706-529-7437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 MEMORIAL DR STE 200",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307208662",
            "telephone_number": "706-226-9355",
            "fax_number": "706-226-9380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKPATRICK",
        "first_name": "JUSTIN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-28",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "203897",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN203897",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003152163B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "02548977",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "1028420",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dooho Brian Kim, MD
• Yeunjung Kim, M.D.
• Erick Anderson Kimmerling, D.O.
• Kristen King
• Tabitha Renee King, PTA
• Carol Deniece Kistler
• Michelle Denise Kitchen, MS CCC-SLP
• Kiwiaba LLC
• Klein Family Chiropractic
• Barry A Klein, D.C.

• Nurse Practitioner in Dalton, GA
• Providers in Dalton, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.