Individual provider Active NPI

Amity Lorraine Kirkland, D.P.M

  • Primary Podiatric Medicine Podiatrist
  • Pendleton, OR
National Provider Identifier
1447645775
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
36.003874 Issued in OH
Practice address
Yellowhawk Tribal Health Center
46314 Timine Way
Pendleton, OR 97801
Phone
(541) 966-9830
NPI assigned
Apr 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Primary Podiatric Medicine Podiatrist 213EP1101X 36.003874 OH Primary

Addresses

Primary practice location

Yellowhawk Tribal Health Center
46314 Timine Way
Pendleton, OR 97801

Mailing address

Yellowhawk Tribal Health Ctr
PO Box 160
Pendleton, OR 97801
Phone (541) 966-9830

Other practice location 1

4100 W 3rd St
Dayton, OH 45428-9000
Phone (859) 582-7485

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230905000141 TX Practitioner - Podiatry 3274996525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yellowhawk Tribal Health CenterGroup PAC ID 6608924121, 17 clinicians

Practice addresses (Care Compare)

46314 Timine Way
Pendleton, OR 97801-9417
Phone (541) 966-9830

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue24
Removal of skin lesions1-10
Removal of nail tissue35
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36.003874OHMDPrimary Podiatric Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Yellowhawk Tribal Health Center CurrentSince May 11, 2023 Accepting new patients

Locations

46314 Timine Way
Pendleton, OR 97801
Phone (541) 966-9830

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1447645775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "YELLOWHAWK TRIBAL HEALTH CTR",
            "address_2": "PO BOX 160",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "97801",
            "telephone_number": "541-966-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "YELLOWHAWK TRIBAL HEALTH CENTER",
            "address_2": "46314 TIMINE WAY",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "97801",
            "telephone_number": "541-966-9830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 W 3rd St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454289000",
            "country_code": "US",
            "telephone_number": "859-582-7485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRKLAND",
        "first_name": "AMITY",
        "middle_name": "LORRAINE",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "OH",
            "license": "36.003874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pendleton, OR

Sources for this page

Verify at the official NPI Registry.