Individual provider Active NPI

Kalee Kirk

  • Medical Physician Assistant
  • Sulphur Springs, TX
National Provider Identifier
1407232010
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
105 Medical PLZ
Sulphur Springs, TX 75482
Phone
(903) 885-3181
Fax
(903) 885-1329
NPI assigned
Aug 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

105 Medical PLZ
Sulphur Springs, TX 75482

Mailing address

PO Box 1367
Sulphur Springs, TX 75483-1367
Phone (903) 885-3181

Other identifiers 11

IdentifierTypeStateIssuer
75-2616977-007OtherTXTRICARE
P01912519OtherTXMEDICARE RAIL ROAD
75-2616977-129OtherTXTRICARE
8HD650OtherTXBCBS
369819302MedicaidTX
596475YNSXOtherTXMEDICARE
75-2616977-002OtherTXTRICARE
8404MBOtherTXBCBS
75-2616977-028OtherTXTRICARE
75-2616977-001OtherTXTRICARE
75-0818167-022OtherTXTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170412000210 TX Practitioner - Physician Assistant 9638455314 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

1367 Dominion PLZ
Tyler, TX 75703-1013
Phone (903) 534-6200

301 W 19TH St
Mt Pleasant, TX 75455-2322
Phone (903) 380-5795

601 Airport Rd
Suite 140
Sulphur Springs, TX 75482-2009
Phone (903) 582-4424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mother Frances Hospital Regional Health Care Center CurrentSince Sep 1, 2017 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Apr 1, 2017 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Apr 1, 2017 Accepting new patients
Dermatology Associates Past Accepting new patients

Locations

105 Medical Plz
Sulphur Springs, TX 75482
Phone (903) 885-3181

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

1720 S Beckham Ave
Ste 102
Tyler, TX 75701
Phone (903) 534-6200

719 W Coke Rd
Ste 3
Winnsboro, TX 75494
Phone (903) 342-3376

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528416000000",
    "number": "1407232010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1367",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754831367",
            "telephone_number": "903-885-3181",
            "fax_number": "903-885-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MEDICAL PLZ",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "75482",
            "telephone_number": "903-885-3181",
            "fax_number": "903-885-1329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "KALEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-05",
        "last_updated": "2018-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-007",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "P01912519",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-129",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8HD650",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "369819302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "596475YNSX",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8404MB",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-028",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-022",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sulphur Springs, TX

Sources for this page

Verify at the official NPI Registry.