Individual provider Active NPI

Dean Kirby, M.D.

  • Family Medicine Physician
  • Ruston, LA
National Provider Identifier
1275503161
Registry record updated Oct 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16431 Issued in LA
Practice address
1200 S Farmerville St
Ruston, LA 71270-5941
Phone
(318) 251-6216
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2009

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 16431 LA Primary

Addresses

Primary practice location

1200 S Farmerville St
Ruston, LA 71270-5941

Mailing address

1200 S Farmerville St
Ruston, LA 71270-5941
Phone (318) 251-6216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20100203000602 LA Practitioner - Family Practice 3870673403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Imaging Clinic, LLCGroup PAC ID 9234290925, 5 clinicians

Practice addresses (Care Compare)

2209 N Bolton Ave
Alexandria, LA 71303-4408
Phone (318) 473-9917

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16431LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Imaging Clinic, LLC CurrentSince Jul 18, 2023 Accepting new patients

Locations

2209 N Bolton Ave
Alexandria, LA 71303
Phone (318) 445-4477

Organizations & group practices 1

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255564800000",
    "number": "1275503161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S FARMERVILLE ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705941",
            "telephone_number": "318-251-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S FARMERVILLE ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705941",
            "telephone_number": "318-251-6216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2009-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "16431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruston, LA

Sources for this page

Verify at the official NPI Registry.