Samuel D Van Kirk, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

A86026 Issued in CA

Practice address

2139 Airpark Dr
Redding, CA 96001-2433

Phone

(530) 247-0270

Fax

(530) 247-0271

NPI assigned

Sep 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 13, 2015 through Apr 13, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samuel.vankirk.1@18130.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/18130/brand/1/csg/1/fhir/r4

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.

• Samuel D Van Kirk MD, Inc

  • Obstetrics Physician
  • Redding, CA
  • NPI 1528646742
  NPD Authorized official
• Dignity Health

  • General Acute Care Hospital
  • Redding, CA
  • NPI 1477671535
  NPD (past)
• James D. Tate, M.D.

  • General Acute Care Hospital
  • Redding, CA
  • NPI 1942204490
  NPD (past)
• Shasta Regional Medical Center, LLC

  • General Acute Care Hospital
  • Redding, CA
  • NPI 1033187182
  NPD (past)
• Northwest Urology, LLC

  • Specialist
  • Portland, OR
  • NPI 1629461397
  NPD (past)
• Women'S Healthcare Associates, LLC

  • Specialist
  • Portland, OR
  • NPI 1346296142
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1417052226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 496084",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960496084",
            "telephone_number": "530-247-0270",
            "fax_number": "530-247-0271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2139 AIRPARK DR",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012433",
            "telephone_number": "530-247-0270",
            "fax_number": "530-247-0271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN KIRK",
        "first_name": "SAMUEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A86026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0094810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Byron James Van Dyke, M.D.
• Mariah Marianne Van Dyke, LM, CPM
• Cheree Nichole Van Eyck
• Jon Alan Van Fossan
• Andrew G Van Horn-Gibson
• Andre' Van Mol, MD
• Van Williams Physical Therapy
• Erin Van Zanten, PT, DPT
• Paloma Vance, LEP
• Ntsaum Steve Vang, MD

• Obstetrics & Gynecology Physician in Redding, CA
• Providers in Redding, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.