Active NPI
Robert Vernon Kirk, PSY.D.
- Clinical Psychologist
- Scottsbluff, NE
National Provider Identifier
1285734145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 709
- Practice address
- 2 W 42ND St
Suite 3200 Medical Plaza North
Scottsbluff, NE 69361-0617 - Phone
- (308) 635-3888
- Fax
- (308) 630-1817
- NPI assigned
- Sep 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 709 | NE | Primary |
| Clinical Psychologist | 103TC0700X | 329152-2501 | UT | |
| Clinical Psychologist | 103TC0700X | 866 | WV |
Addresses
Primary practice location
2 W 42ND St
Suite 3200 Medical Plaza North
Scottsbluff, NE 69361-0617
Mailing address
2 W 42ND St
Suite 3200 Medical Plaza North
Scottsbluff, NE 69361-0617
Phone (308) 635-3888
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 329152-2501 | UT | MD | Clinical Psychologist |
| 709 | NE | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Behavioral Care, Inc. | Past | Accepting new patients | |
| Regional West Physicians Clinic | Past | Accepting new patients |
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.
-
- Rural Health Clinic/Center
- Mitchell, NE
- NPI 1992703425
-
- Professional Counselor
- Salt Lake City, UT
- NPI 1013981935
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237161600000",
"number": "1285734145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 W 42ND ST",
"address_2": "SUITE 3200 MEDICAL PLAZA NORTH",
"city": "SCOTTSBLUFF",
"state": "NE",
"postal_code": "693610617",
"telephone_number": "308-635-3888",
"fax_number": "308-630-1817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 W 42ND ST",
"address_2": "SUITE 3200 MEDICAL PLAZA NORTH",
"city": "SCOTTSBLUFF",
"state": "NE",
"postal_code": "693610617",
"telephone_number": "308-635-3888",
"fax_number": "308-630-1817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRK",
"first_name": "ROBERT",
"middle_name": "VERNON",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2009-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NE",
"license": "709",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "329152-2501",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WV",
"license": "866",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsbluff, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.