Brent Logan Kirby, MA

Primary specialty

Pastoral CounselorTaxonomy code 101YP1600X

Practice address

17345 N 150 E
Summitville, IN 46070-9121

Phone

(907) 690-1701

NPI assigned

Aug 19, 2021

Last updated

Aug 19, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1154097111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 305",
            "city": "SUMMITVILLE",
            "state": "IN",
            "postal_code": "460700305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17345 N 150 E",
            "city": "SUMMITVILLE",
            "state": "IN",
            "postal_code": "460709121",
            "telephone_number": "907-690-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "BRENT",
        "middle_name": "LOGAN",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-19",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Hospitals of Indiana Inc (Summitville Medical Arts)
• Kimberly S. Hodge, PHD, RN, ACNS-BC
• Miggin Montanay Hutson
• Abigail L Manwell
• Amanda Middleton, MOT, OTR/L
• Putnam County Hospital (Summit Health and Living)
• Abe Rosenthall, DMD
• Megan Nicole Stroup, LSW

• Pastoral Counselor in Summitville, IN
• Providers in Summitville, IN by specialty
• Pastoral Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.