Desiree D Kirk, AGNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

10010097 Issued in OR

Practice address

17727 E Burnside St
Portland, OR 97233

Phone

(503) 215-9800

NPI assigned

Sep 26, 2023

Sex

Female

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

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1346029600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17727 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97233",
            "telephone_number": "503-215-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17727 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97233",
            "telephone_number": "503-215-9800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4400 NE halsey st.",
            "address_2": "building 1, suite 200",
            "address_purpose": "LOCATION",
            "city": "portland",
            "state": "OR",
            "postal_code": "97213",
            "country_code": "US",
            "telephone_number": "503-215-6556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRK",
        "first_name": "DESIREE",
        "middle_name": "D",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-26",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "10010097",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "10010097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Kirgin
• Jacquelynn Kirihara, ND
• Faith N Kirirah, NP
• Kirit S Shah M.D., P.C.
• Kirk Parker OD P C
• Edward Paul Kirk, MD
• Hannah Rae Kirk, DO
• Elzabeth Kirkaldie, LCSW
• Alana Kirkendall
• Eric Blaine Kirker, MD

• Gerontology Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Gerontology Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.