Individual provider Active NPI

Samantha J Kirk, NP

  • Family Nurse Practitioner
  • Bloomington, IN
National Provider Identifier
1376243154
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71013673A Issued in IN
Practice address
2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone
(812) 353-3719
NPI assigned
Mar 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71013673A IN
Family Nurse Practitioner 363LF0000X 71013673A IN Primary

Addresses

Primary practice location

2651 E Discovery Pkwy
Bloomington, IN 47408-9059

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other identifiers 1

IdentifierTypeStateIssuer
090540879OtherINMEDICARE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address skirk@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20230626000221 IN Practitioner - Nurse Practitioner 1951769819 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
Indiana University Health Southern Indiana Physicians LLCGroup PAC ID 6204748197, 474 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-9250

Hospital & facility affiliations

  • Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051
  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71013673AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Southern Indiana Physicians, LLC Nurse Practitioner CurrentSince Aug 13, 2023 Accepting new patients
Iu Health Medical Group, LLC Nurse Practitioner CurrentSince Jan 1, 2026 Accepting new patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Aug 13, 2023 Accepting new patients

Locations

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

2651 E Discovery Pkwy
Bloomington, IN 47408
Phone (812) 353-9147

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

2209 John R Wooden Dr
Martinsville, IN 46151
Phone (765) 342-3364

Interoperability endpoints

  • Direct secure messaging: skirk@direct.iuhealth.org

Organizations & group practices 3

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": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1376243154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 E DISCOVERY PKWY",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474089059",
            "telephone_number": "812-353-3719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "SAMANTHA",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71013673A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71013673A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "090540879",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skirk@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2651 E Discovery Pkwy",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474089059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.