Amanda J Kirk, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2944 Issued in TN

Practice address

430 Neal St
Cookeville, TN 38501-0916

Phone

(931) 528-6411

Fax

(931) 372-0380

NPI assigned

Sep 8, 2010

Sex

Female

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 TN

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

Specialty

Optometry

Education

Southern College of Optometry, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Centers of Tennessee, LLCGroup PAC ID 1355379256, 18 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: akirk@ecotn.intellechartdirect.net

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.

• Eye Centers of Tennessee, LLC

  • Ophthalmology Physician
  • Crossville, TN
  • NPI 1104940790

  Optometrist

  Medicare reassignment Care Compare group NPD
• Lighthouse Optical of Tennessee, LLC

  • Optometrist
  • Cookeville, TN
  • NPI 1609066703
  Medicare reassignment NPD

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1477860708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 NEAL ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385010916",
            "telephone_number": "931-528-6411",
            "fax_number": "931-372-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 NEAL ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385010916",
            "telephone_number": "931-528-6411",
            "fax_number": "931-372-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "AMANDA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-08",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC-BS",
            "identifier": "4301195",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Paige King, COTA
• Teena M King, RN
• Terra King, CPNP
• Kristi Leigh Kinnard, LPN
• Nathalie Kintz
• Christopher Phillip Klamm
• Robby R Klawitter, CRNP
• Brent J Klinkhammer, MD
• Richard Lawrence Klopfenstein Sr., COTA
• Christopher J Klugewicz, M.D.

• Optometrist in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.