Individual provider Active NPI

Jeffrey David Kirkpatrick, M.D.

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1376596254
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
19503 Issued in AZ
Practice address
1818 E Sky Harbor Cir N Ste 150
Phoenix, AZ 85034-3410
Phone
(480) 238-5778
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 10153958-1205 UT
Pediatrics Physician 208000000X 19503 AZ
Internal Medicine Physician 207R00000X 19503 AZ Primary

Addresses

Primary practice location

1818 E Sky Harbor Cir N Ste 150
Phoenix, AZ 85034-3410

Mailing address

1716 W Dawn Dr
Tempe, AZ 85284-1214
Phone (480) 223-8925

Other practice location 1

1735 S Redwood Rd Ste 115
Salt Lake City, UT 84104-5107
Phone (801) 973-4434

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040929001030 AZ Practitioner - Internal Medicine 8820067556 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10153958-1205UTMDInternal Medicine Physician
19503AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chandler Regional Medical Center Past Accepting new patients
Dignity Community Care Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1376596254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 W DAWN DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852841214",
            "telephone_number": "480-223-8925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 E SKY HARBOR CIR N STE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850343410",
            "telephone_number": "480-238-5778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1735 S Redwood Rd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841045107",
            "country_code": "US",
            "telephone_number": "801-973-4434",
            "fax_number": "801-973-4414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRKPATRICK",
        "first_name": "JEFFREY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "10153958-1205",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "19503",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "19503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.