Archie Thomas Kirkley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7567 Issued in GA

Practice address

125 Church St
Vidalia, GA 30474-4770

Phone

(912) 538-8484

Fax

(912) 538-8665

NPI assigned

May 12, 2015

Last updated

Apr 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: archie.kirkley@hca5.eclinicaldirectplus.com
• Direct secure messaging: archie.kirkley@srpcc.gadirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Meadows Multispecialty Associates, LLC

  • Internal Medicine Physician
  • Lyons, GA
  • NPI 1952990533
  Medicare reassignment
• Southeast Regional Primary Care Corporation

  • Multi-Specialty Clinic/Center
  • Vidalia, GA
  • NPI 1467568907
  NPD

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1427436393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 CHURCH ST",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304744770",
            "telephone_number": "912-538-8484",
            "fax_number": "912-538-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CHURCH ST",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304744770",
            "telephone_number": "912-538-8484",
            "fax_number": "912-538-8665"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "414 Lugenia Dr",
            "address_purpose": "LOCATION",
            "city": "Vidalia",
            "state": "GA",
            "postal_code": "304747210",
            "country_code": "US",
            "telephone_number": "912-537-9355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1811 Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Vidalia",
            "state": "GA",
            "postal_code": "304748921",
            "country_code": "US",
            "telephone_number": "125-350-8029",
            "fax_number": "912-538-8665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRKLEY",
        "first_name": "ARCHIE",
        "middle_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-12",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA COMPOSITE MEDICAL BOARD",
            "identifier": "007567",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Doo Yeon Kang, OD
• Keis Testing, LLC
• Kristen Keown
• Colleen Marie Kerrigan, PA
• Rick L Kimbrel I, D.M.D.
• Sarah B Kitchens, LPC
• Tosaporn Krasaeath, MD
• Kimberly A Krupack, DPT
• Kurt P Hofmann MD LLC
• Mary Lesie Kyzer, PTA

• Physician Assistant in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.