NPIMap

Individual provider Active NPI

Clint Forrest Kirk, DO

  • Orthopaedic Surgery Physician
  • Lawton, OK
National Provider Identifier
1306882980
Registry record updated Jan 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
3331 Issued in OK
Practice address
110 NW 31St 2ND Floor
Lawton, OK 73505
Phone
(580) 357-3671
Fax
(580) 357-1256
NPI assigned
Jun 21, 2006
Last updated
Jan 21, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 3331 OK Primary

Addresses

Primary practice location

110 NW 31St 2ND Floor
Lawton, OK 73505

Mailing address

PO Box 785
Lawton, OK 73502
Phone (580) 357-9984

Other identifiers 10

IdentifierTypeStateIssuer
P00007143OtherOKRR MEDICARE
100169700BMedicaidOK
731612928OtherOKBLUELINCS
2012060OtherOKFIRST HEALTH
5433409OtherOKFIRST HEALTH CCN
731612928OtherOKCOMPCHOICE
731612928001OtherOKBC/BS
731612928OtherOKPPO OK
5433409OtherOKMAIL HANDLERS
8608608002OtherOKCIGNA PPO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041022001113 OK Practitioner - Orthopedic Surgery 1355339144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Oklahoma State University College of Osteopathic Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

110 NW 31St St
FL 2
Lawton, OK 73505-6100
Phone (580) 357-3671

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement28
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3331OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Comanche County Healthcare Corporation CurrentSince Jan 2, 2009 Accepting new patients
Comanche County Healthcare Corporation Current Accepting new patients
Comanche County Healthcare CurrentSince Jan 2, 2009 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Comanche County Healthcare Past Accepting new patients
Orthopedic Center of Muskogee PastSince Jan 1, 2001 Accepting new patients
Comanche County Hospital Authority Past Accepting new patients
Ahs Henryetta Hospital LLC Past Accepting new patients

Locations

110 NW 31st St
Fl 2
Lawton, OK 73505
Phone (580) 248-5255

3201 W Gore Blvd
Ste 201
Lawton, OK 73505
Phone (580) 357-2261

3201 W Gore Blvd
Ste 300
Lawton, OK 73505
Phone (580) 248-5255

Interoperability endpoints

  • Direct secure messaging: clint.kirk@mmg.eclinicaldirectplus.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1306882980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 785",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73502",
            "telephone_number": "580-357-9984",
            "fax_number": "580-357-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 NW 31ST 2ND FLOOR",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73505",
            "telephone_number": "580-357-3671",
            "fax_number": "580-357-1256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "CLINT",
        "middle_name": "FORREST",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OK",
            "license": "3331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00007143",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100169700B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUELINCS",
            "identifier": "731612928",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2012060",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH CCN",
            "identifier": "5433409",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPCHOICE",
            "identifier": "731612928",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "731612928001",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPO OK",
            "identifier": "731612928",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAIL HANDLERS",
            "identifier": "5433409",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PPO",
            "identifier": "8608608002",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.