Individual provider Active NPI

Keri Kirk, PH.D.

  • Clinical Psychologist
  • Ft Belvoir, VA
National Provider Identifier
1194373993
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810006290 Issued in VA
Practice address
9300 Dewitt Loop
Ft Belvoir, VA 22060-5285
Phone
(571) 231-3224
NPI assigned
Aug 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 0810006290 VA Primary

Addresses

Primary practice location

9300 Dewitt Loop
Ft Belvoir, VA 22060-5285

Mailing address

9300 Dewitt Loop
Ft Belvoir, VA 22060-5285
Phone (571) 231-4495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210126002252 DC Practitioner - Clinical Psychologist 8820402225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

4151 Bladensburg Rd
Colmar Manor, MD 20722-1928
Phone (301) 699-7700

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0810006290VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Well & Just, LLC Clinical Current Accepting new patients
Medstar Medical Group II LLC Multi-Specialty CurrentSince Nov 16, 2020 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

4151 Bladensburg Rd
Colmar Manor, MD 20722
Phone (301) 699-7700

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.

NPI Registry JSON

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1194373993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "571-231-4495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "571-231-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "KERI",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810006290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Belvoir, VA

Sources for this page

Verify at the official NPI Registry.