NPIMap

Individual provider Active NPI

Kanwaldeep Kaur Virk, M.D.

  • Internal Medicine Physician
  • Bullhead City, AZ
National Provider Identifier
1124648142
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
70412 Issued in AZ
Practice address
2500 Canyon Rd # 2
Bullhead City, AZ 86442-8624
Phone
(928) 763-9290
NPI assigned
Apr 20, 2020
Last updated
May 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 24356 NV
Internal Medicine Physician 207R00000X 70412 AZ Primary

Addresses

Primary practice location

2500 Canyon Rd # 2
Bullhead City, AZ 86442-8624

Mailing address

2500 Canyon Rd # 2
Bullhead City, AZ 86442-8624
Phone (928) 763-9290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, NV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231117002976 AZ Practitioner - Internal Medicine 7517315229 Reassigns benefits to 1 organization
I20231117003040 NV Practitioner - Internal Medicine 7517315229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bullhead City Clinic CorpGroup PAC ID 1052317575, 23 clinicians
Paragon Physical Therapy and Rehab LLCGroup PAC ID 4284902339, 87 clinicians

Practice addresses (Care Compare)

2500 Canyon Rd
Bullhead City, AZ 86442-8624

2585 Miracle Mile
Bullhead City, AZ 86442-7522

2735 Silver Creek Rd
Bullhead City, AZ 86442-7924
Phone (928) 763-2273

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.8 of 100Reported as apm
Quality
77.6
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bullhead City Clinic Corp CurrentSince Nov 15, 2023 Accepting new patients
Bullhead City Clinic Corp CurrentSince Nov 15, 2023 Accepting new patients

Locations

2500 Canyon Rd
Bldg B
Bullhead City, AZ 86442
Phone (928) 763-9290

2500 Canyon Rd
Ste B2
Bullhead City, AZ 86442
Phone (928) 763-9290

2735 Silver Creek Rd
Bullhead City, AZ 86442
Phone (520) 763-2273

1955 S Casino Dr
Ste 118
Laughlin, NV 89029
Phone (702) 299-7203

Interoperability endpoints

  • Direct secure messaging: kanwaldeep.virk.1@1575.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 9

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": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1124648142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 CANYON RD # 2",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428624",
            "telephone_number": "928-763-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 CANYON RD # 2",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428624",
            "telephone_number": "928-763-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRK",
        "first_name": "KANWALDEEP",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-20",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "24356",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "70412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullhead City, AZ

Sources for this page

Verify at the official NPI Registry.