Individual provider Active NPI

Shawn Alan Kirkpatrick, IDC

  • Independent Duty Corpsman
  • Norfolk, VA
National Provider Identifier
1154401693
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty CorpsmanTaxonomy code 1710I1002X
Practice address
2155 11TH St
Norfolk, VA 23521-3017
Phone
(757) 462-4786
Fax
(757) 462-7005
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X Primary

Addresses

Primary practice location

2155 11TH St
Norfolk, VA 23521-3017

Mailing address

2155 11TH St
Norfolk, VA 23521-3017
Phone (757) 462-4786

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

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154401693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 11TH ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235213017",
            "telephone_number": "757-462-4786",
            "fax_number": "757-462-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 11TH ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235213017",
            "telephone_number": "757-462-4786",
            "fax_number": "757-462-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKPATRICK",
        "first_name": "SHAWN",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.