Active NPI
Kimberly J Kirby
- Peer Specialist
- Berea, KY
National Provider Identifier
1578287314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 1186485
- Practice address
- 108 Jefferson CT
Berea, KY 40403-1544 - Phone
- (859) 358-2059
- NPI assigned
- Sep 26, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 1186485 | KY | Primary |
Addresses
Primary practice location
108 Jefferson CT
Berea, KY 40403-1544
Mailing address
108 Jefferson CT
Berea, KY 40403-1544
Phone (859) 358-2059
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1186485 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1186485 | KY | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664150400000",
"number": "1578287314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 JEFFERSON CT",
"city": "BEREA",
"state": "KY",
"postal_code": "404031544",
"telephone_number": "859-358-2059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 JEFFERSON CT",
"city": "BEREA",
"state": "KY",
"postal_code": "404031544",
"telephone_number": "859-358-2059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRBY",
"first_name": "KIMBERLY",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-26",
"last_updated": "2022-09-26",
"certification_date": "2022-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "KY",
"license": "1186485",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1186485",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Berea, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.