NPIMap

Individual provider Active NPI

John Kennon Kirk, M.D.

  • Family Medicine Physician
  • Juneau, AK
National Provider Identifier
1578769428
Registry record updated Jan 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
TL-2561 Issued in CO
Practice address
3245 Hospital Drive
Juneau, AK 99801
Phone
(907) 463-4040
Fax
(907) 463-4075
NPI assigned
Jun 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TL-2561 CO Primary

Addresses

Primary practice location

3245 Hospital Drive
Juneau, AK 99801

Mailing address

222 Tongass Drive
Sitka, AK 99835
Phone (907) 966-8423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AK2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110104000212 TX Practitioner - Family Practice 8820286016 Reassigns benefits to 1 organization
I20190722001180 AK Practitioner - Family Practice 8820286016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Eastern Virginia Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bartlett Regional HospitalGroup PAC ID 1759469174, 25 clinicians

Practice addresses (Care Compare)

3260 Hospital Dr
Juneau, AK 99801-7808

3268 Hospital Dr
Suite a
Juneau, AK 99801-7800
Phone (907) 796-8713

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TL-2561COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Alaska Regional Health Consortium CurrentSince Dec 1, 2010 Accepting new patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Dec 1, 2010 Accepting new patients
Bartlett Regional Hospital CurrentSince May 25, 2019 Accepting new patients
Alpine Dermatology, LLC Past Accepting new patients

Locations

37 Chilkat Ave
Haines, AK 99827
Phone (907) 463-4040

3268 Hospital Dr
Ste A
Juneau, AK 99801
Phone (907) 586-2700

3245 Hospital Dr
Juneau, AK 99801
Phone (907) 463-4040

3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000

3225 Hospital Dr
Unit 101A
Juneau, AK 99801
Phone (907) 523-5411

3260 Hospital Dr
Juneau, AK 99801
Phone (907) 796-8427

1200 Salmon Creek Ln
Juneau, AK 99801
Phone (907) 463-4031

222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8519

Organizations & group practices 5

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.

Hospital & facility affiliations 37

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295827200000",
    "number": "1578769428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 TONGASS DRIVE",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "99835",
            "telephone_number": "907-966-8423",
            "fax_number": "907-966-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 HOSPITAL DRIVE",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "99801",
            "telephone_number": "907-463-4040",
            "fax_number": "907-463-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "JOHN",
        "middle_name": "KENNON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2011-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "TL-2561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juneau, AK

Sources for this page

Verify at the official NPI Registry.