Individual provider Active NPI

Deborah Kirkpatrick

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Jackson, MS
National Provider Identifier
1386749471
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
R576824 Issued in MS
Practice address
1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116
Phone
(601) 368-3914
Fax
(601) 364-1305
NPI assigned
Sep 13, 2006
Last updated
Jan 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X R576824 MS Primary

Addresses

Primary practice location

1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116

Mailing address

1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116
Phone (601) 368-3914

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R576824MSMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1386749471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165116",
            "telephone_number": "601-368-3914",
            "fax_number": "601-364-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165116",
            "telephone_number": "601-368-3914",
            "fax_number": "601-364-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKPATRICK",
        "first_name": "DEBORAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MS",
            "license": "R576824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; 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.