Active NPI
John Kirby, MD
- Physical Medicine & Rehabilitation Physician
- Fresno, CA
National Provider Identifier
1093734543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- G15922
- Practice address
- 445 S Cedar Ave
Fresno, CA 93702-2907 - Phone
- (559) 459-5719
- Fax
- (559) 459-6900
- NPI assigned
- Jul 18, 2006
- 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 |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | G15922 | CA | Primary |
Addresses
Primary practice location
445 S Cedar Ave
Fresno, CA 93702-2907
Mailing address
1534 N Cherry LN
Clovis, CA 93619-7604
Phone (559) 298-9455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G159220 | Medicaid | CA |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G15922 | CA | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1093734543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1534 N CHERRY LN",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936197604",
"telephone_number": "559-298-9455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 S CEDAR AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937022907",
"telephone_number": "559-459-5719",
"fax_number": "559-459-6900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRBY",
"first_name": "JOHN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "CA",
"license": "G15922",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G159220",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.