Individual provider Active NPI

Patricia Gail Kirkpatrick, FNP-C

  • Family Nurse Practitioner
  • Keokuk, IA
National Provider Identifier
1508238635
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A102994 Issued in IA
Practice address
20 Village Circle
Keokuk, IA 52632-2040
Phone
(319) 524-3462
Fax
(319) 209-2149
NPI assigned
Oct 28, 2015
Last updated
Oct 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A102994 IA Primary

Addresses

Primary practice location

20 Village Circle
Keokuk, IA 52632-2040

Mailing address

2753 260TH St.
New London, IA 52645
Phone (319) 217-9035

Other practice location 1

100 Care Circle
New London, IA 52645-1767
Phone (319) 367-5753

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20160113000443 IA Practitioner - Nurse Practitioner 6901108604 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A102994IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optimae Lifeservices, Inc, CurrentSince Sep 15, 2016 Accepting new patients
Optimae Lifeservices,Inc. Current Accepting new patients
Stanley Mathew, MD PLLC CurrentSince Jan 1, 2020 Accepting new patients
Nurse in the House, Inc. Past Accepting new patients

Locations

1026 A Ave NE
Cedar Rapids, IA 52402
Phone (319) 369-5970

2201 W Jefferson Ave
Fairfield, IA 52556
Phone (641) 472-5771

301 W Burlington Ave
Fairfield, IA 52556
Phone (641) 472-1684

20 Village Cir
Keokuk, IA 52632
Phone (319) 524-3462

100 Care Circle St
New London, IA 52645
Phone (319) 367-5753

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1508238635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2753 260TH ST.",
            "city": "NEW LONDON",
            "state": "IA",
            "postal_code": "52645",
            "telephone_number": "319-217-9035",
            "fax_number": "319-209-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 VILLAGE CIRCLE",
            "city": "KEOKUK",
            "state": "IA",
            "postal_code": "526322040",
            "telephone_number": "319-524-3462",
            "fax_number": "319-209-2149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Care Circle",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "IA",
            "postal_code": "526451767",
            "country_code": "US",
            "telephone_number": "319-367-5753",
            "fax_number": "319-209-2149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRKPATRICK",
        "first_name": "PATRICIA",
        "middle_name": "GAIL",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-28",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A102994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keokuk, IA

Sources for this page

Verify at the official NPI Registry.