Individual provider Active NPI

Michael V. Kirch, PHD

  • Psychologist
  • High Point, NC
National Provider Identifier
1093734295
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3128 Issued in NC
Practice address
1208 Eastchester Dr
Suite 200
High Point, NC 27265-3170
Phone
(336) 802-2536
Fax
(336) 802-2534
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3128 NC Primary

Addresses

Primary practice location

1208 Eastchester Dr
Suite 200
High Point, NC 27265-3170

Mailing address

1701 Westchester Drive
Suite 850
High Point, NC 27262-7254
Phone (336) 802-2536

Other identifiers 1

IdentifierTypeStateIssuer
6000731MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050914000655 NC Practitioner - Clinical Psychologist 7113960329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wake Forest Health Network LLCGroup PAC ID 4183538895, 276 clinicians

Practice addresses (Care Compare)

1208 Eastchester Dr
Suite 200
High Point, NC 27265-3165
Phone (336) 802-2205

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3128NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest Health Network, LLC CurrentSince Jun 13, 2005 Accepting new patients
Wake Forest Health Network LLC Current Accepting new patients
Cornerstone Health Care PA CurrentSince Jun 13, 2005 Accepting new patients
Cornerstone Health Care PA Past Accepting new patients

Locations

1814 Westchester Dr
Ste 402
High Point, NC 27262
Phone (336) 802-5505

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

1208 Eastchester Dr
Ste 200
High Point, NC 27265
Phone (336) 501-8300

1701 Westchester Dr
Ste 850
High Point, NC 27262
Phone (336) 802-2400

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1093734295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WESTCHESTER DRIVE",
            "address_2": "SUITE 850",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627254",
            "telephone_number": "336-802-2536",
            "fax_number": "336-802-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 EASTCHESTER DR",
            "address_2": "SUITE 200",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272653170",
            "telephone_number": "336-802-2536",
            "fax_number": "336-802-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRCH",
        "first_name": "MICHAEL",
        "middle_name": "V.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "3128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000731",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.