Organization Active NPI

Kirby Plastic Surgery, PLLC

  • Plastic Surgery Physician
  • Fort Worth, TX
National Provider Identifier
1386937076
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
N7124 Issued in TX
Legal business name
KIRBY PLASTIC SURGERY, PLLC
Practice address
5075 Edwards Ranch Rd
Fort Worth, TX 76109-4133
Phone
(817) 292-4200
Fax
(817) 292-4205
NPI assigned
May 27, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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

Authorized official

Name
Dr. Emily J Kirby, MD
Title
Member, Kirby Plastic Surgery, PLLC
Phone
(817) 292-4200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X N7124 TX Primary

Addresses

Primary practice location

5075 Edwards Ranch Rd
Fort Worth, TX 76109-4133

Mailing address

5075 Edwards Ranch Rd
Fort Worth, TX 76109-4133
Phone (817) 292-4200

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2237486Kirby Plastic Surgery, PLLC5075 Edwards Ranch Rd, Fort Worth, TX 76109Certificate of waiverSep 23, 2027

National Provider Directory

National Provider Directory

Locations

7250 Hawkins View Dr
Ste 412
Ft Worth, TX 76132
Phone (817) 292-4200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1306454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572480000000",
    "number": "1386937076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5075 EDWARDS RANCH RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094133",
            "telephone_number": "817-292-4200",
            "fax_number": "817-292-4205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5075 EDWARDS RANCH RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094133",
            "telephone_number": "817-292-4200",
            "fax_number": "817-292-4205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRBY PLASTIC SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-27",
        "last_updated": "2019-10-31",
        "status": "A",
        "authorized_official_last_name": "KIRBY",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEMBER, KIRBY PLASTIC SURGERY, PLLC",
        "authorized_official_telephone_number": "817-292-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "N7124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.