NPIMap

Organization Active NPI

Kirk Family Practice, LLC

  • Family Medicine Physician
  • Smyrna, DE
National Provider Identifier
1548485931
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
KIRK FAMILY PRACTICE, LLC
Practice address
100 S Main Street
Suite 205
Smyrna, DE 19977-1433
Phone
(302) 653-6022
Fax
(302) 389-1094
NPI assigned
Apr 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Deborah Kirk, M.D.
Title
Owner
Phone
(302) 653-6022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

100 S Main Street
Suite 205
Smyrna, DE 19977-1433

Mailing address

100 S Main Street
Suite 205
Smyrna, DE 19977-1433
Phone (302) 653-6022

Other identifiers 1

IdentifierTypeStateIssuer
6561586OtherDECIGNA

National Provider Directory

National Provider Directory
Tax ID family
Kirk Family Practice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548485931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S MAIN STREET",
            "address_2": "SUITE 205",
            "city": "SMYRNA",
            "state": "DE",
            "postal_code": "199771433",
            "telephone_number": "302-653-6022",
            "fax_number": "302-389-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S MAIN STREET",
            "address_2": "SUITE 205",
            "city": "SMYRNA",
            "state": "DE",
            "postal_code": "199771433",
            "telephone_number": "302-653-6022",
            "fax_number": "302-389-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRK FAMILY PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-653-6022",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6561586",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.