John Mark Kirk, D.O.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

DO 231 Issued in AL

Practice address

1315 13TH Ave SE
Decatur, AL 35601-4308

Phone

(256) 260-7306

Fax

(256) 350-1661

NPI assigned

Mar 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Mental Health Center of North Central Alabama Inc.

  • Community/Behavioral Health Agency
  • Decatur, AL
  • NPI 1124193636
  NPD (past)

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1295863371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2241 THORNTON TAYLOR PKWY",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373343637",
            "telephone_number": "256-260-7306",
            "fax_number": "256-350-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 13TH AVE SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014308",
            "telephone_number": "256-260-7306",
            "fax_number": "256-350-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "JOHN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TN",
            "license": "1713",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "AL",
            "license": "DO 231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Michelle King, LPC
• Felicia Annette King
• Marlene J King
• Kingdom Kare Group Homes, LLC
• Catherine Kelsey Kinslow, CRNP
• Kelsey Kirk, PT. DPT
• Dolores Kisbey-Green, PT
• Brooke Marie Knapp
• Debra Darnice Knapp, LMT
• Bailey Gardner Knight, DPT, PT

• All providers in Decatur, AL
• Child & Adolescent Psychiatry Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; 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.