Alton R Kirk, PH.D., CLINICAL PSYC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301002055 Issued in MI

Practice address

1451 E Lansing Dr
Suite 224
East Lansing, MI 48823-7785

Phone

(517) 351-9006

Fax

(517) 351-6105

NPI assigned

Feb 22, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203638400000",
    "number": "1457520546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 E LANSING DR",
            "address_2": "SUITE 224",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488237785",
            "telephone_number": "517-351-9006",
            "fax_number": "517-351-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 E LANSING DR",
            "address_2": "SUITE 224",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488237785",
            "telephone_number": "517-351-9006",
            "fax_number": "517-351-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "ALTON",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D., CLINICAL PSYC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-22",
        "last_updated": "2008-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301002055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "0005774436",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDERS HEALTH PLAN",
            "identifier": "0005774436",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCCLAREN HEALTH CARE",
            "identifier": "0005774431",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005774431",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ginga Estee Kimbro, DC
• Kersten Mary Kimmerly Kiebler, LMSW
• Jeffrey Travis King, DPT
• Kevin Kingshott, DNP-FNP
• Kristen Kirchner
• Amy L Kirkconnell, RPH
• Travis Kiser, AT, ATC
• Randal Klatt
• Daniel R Klein, DDS
• David H Klein, MSW,ACSW,PHD

• Clinical Psychologist in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.