Individual provider Active NPI

Nicky Mathew Kirk, D.C.

  • Chiropractor
  • Frisco, TX
National Provider Identifier
1578870432
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
14039 Issued in TX
Practice address
3800 Gaylord Pkwy Ste 795
Frisco, TX 75034-1102
Phone
(214) 902-3400
NPI assigned
Sep 13, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 14039 TX Primary

Addresses

Primary practice location

3800 Gaylord Pkwy Ste 795
Frisco, TX 75034-1102

Mailing address

1612 Mack LN
Little Elm, TX 75068-1996
Phone (972) 679-7894

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190507000684 TX Practitioner - Chiropractic 3274670286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synapse Human Performance Centers, Inc.Group PAC ID 0749610681, 5 clinicians

Practice addresses (Care Compare)

3800 Gaylord Pkwy
Suite 795
Frisco, TX 75034-1102
Phone (214) 902-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14039TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Hpi LLC Chiropractor Current Accepting new patients

Locations

503 Calle Ext S
Dorado, PR 00646
Phone (787) 796-2900

Interoperability endpoints

  • Direct secure messaging: nicky.kirk.1@23964.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1578870432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 MACK LN",
            "city": "LITTLE ELM",
            "state": "TX",
            "postal_code": "750681996",
            "telephone_number": "972-679-7894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 GAYLORD PKWY STE 795",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750341102",
            "telephone_number": "214-902-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "NICKY",
        "middle_name": "MATHEW",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-13",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "14039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.