Individual provider Active NPI

Cheryl Cathleen Kirby, PA

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1285834705
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
875 Issued in OK
Practice address
5401 N Portland
Ste 310
Oklahoma City, OK 73112-2082
Phone
(405) 951-4160
Fax
(405) 951-4162
NPI assigned
Jul 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 875 OK Primary

Addresses

Primary practice location

5401 N Portland
Ste 310
Oklahoma City, OK 73112-2082

Mailing address

5401 N Portland
Ste 310
Oklahoma City, OK 73112-2082
Phone (405) 951-4160

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111103000588 OK Practitioner - Physician Assistant 5193998383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

4300 McAuley Blvd
Oklahoma City, OK 73120-8302
Phone (405) 936-5455

4300 W Memorial Rd
Oklahoma City, OK 73120-8304
Phone (405) 755-1515

4345 W Memorial Rd
Suite 110
Oklahoma City, OK 73134-1717
Phone (405) 418-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
875OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ckirby412501@directc.mercy.net

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1285834705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 N PORTLAND",
            "address_2": "STE 310",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122082",
            "telephone_number": "405-951-4160",
            "fax_number": "405-951-4162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 N PORTLAND",
            "address_2": "STE 310",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122082",
            "telephone_number": "405-951-4160",
            "fax_number": "405-951-4162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "CHERYL",
        "middle_name": "CATHLEEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.