Individual provider Active NPI

Jeanne Marie Kirkland, M.D.

  • Family Medicine Physician
  • Dayton, OH
National Provider Identifier
1124108980
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
45543 Issued in OH
Practice address
5928 Springboro Pike
Dayton, OH 45449-3250
Phone
(937) 433-0220
Fax
(937) 434-4405
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 45543 OH Primary

Addresses

Primary practice location

5928 Springboro Pike
Dayton, OH 45449-3250

Mailing address

5928 Springboro Pike
Dayton, OH 45449-3250
Phone (937) 433-0220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120120000112 OH Practitioner - Family Practice 3779750518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at San Antonio, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clem Kirkland, M.D., IncGroup PAC ID 5193758951, 2 clinicians

Practice addresses (Care Compare)

5928 Springboro Pike
Dayton, OH 45449-3250
Phone (937) 433-0220

Hospital & facility affiliations

  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
  • Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239
  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051
  • Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions12
Removal or shaving of skin growth17

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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45543OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clem Kirkland, M.D., Inc Family Medicine CurrentSince Oct 1, 1992 Accepting new patients
Midwest Ultrasound, Inc. PastSince Oct 1, 1992 Accepting new patients

Locations

5928 Springboro Pike
Dayton, OH 45449
Phone (937) 433-0220

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4WhyRArSk37mMNgPi8abRFnIJRbnJPpW/

Organizations & group practices 2

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285632000000",
    "number": "1124108980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5928 SPRINGBORO PIKE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454493250",
            "telephone_number": "937-433-0220",
            "fax_number": "937-433-0623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5928 SPRINGBORO PIKE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454493250",
            "telephone_number": "937-433-0220",
            "fax_number": "937-434-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKLAND",
        "first_name": "JEANNE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2010-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "45543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.