NPIMap

Organization Active NPI

Karen S. Kirk, PHD, PLLC

  • Clinical Psychologist
  • Wilmington, NC
National Provider Identifier
1588912513
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3894 Issued in NC
Legal business name
KAREN S. KIRK, PHD, PLLC
Doing business as
Cape Fear Developmental Therapies PLLC
Cape Fear Developmental Therapies, PLLC
Practice address
2601 Iron Gate Dr Ste 101
Wilmington, NC 28412-6624
Phone
(910) 202-9113
Fax
(910) 202-9289
NPI assigned
Aug 23, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Authorized official

Name
Dr. Karen S. Kirk, PHDNPI 1720235542
Title
Owner / Manager
Phone
(910) 202-9113

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 3894 NC Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

2601 Iron Gate Dr Ste 101
Wilmington, NC 28412-6624

Mailing address

P.O. Box 16570
Wilmington, NC 28408
Phone (910) 202-9113

Other practice location 1

2460 Delaney Ave
Wilmington, NC 28403-6062
Phone (910) 202-9113

Other identifiers 1

IdentifierTypeStateIssuer
6008801MedicaidNC

Other names 2

  • Cape Fear Developmental Therapies PLLC Doing business as
  • Cape Fear Developmental Therapies, PLLC Doing business as

National Provider Directory

National Provider Directory

Locations

2601 Iron Gate Dr
Ste 101
Wilmington, NC 28412
Phone (910) 202-9113

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1345680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1588912513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 16570",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28408",
            "telephone_number": "910-202-9113",
            "fax_number": "910-202-9289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 IRON GATE DR STE 101",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126624",
            "telephone_number": "910-202-9113",
            "fax_number": "910-202-9289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2460 Delaney Ave",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284036062",
            "country_code": "US",
            "telephone_number": "910-202-9113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KAREN S. KIRK, PHD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-23",
        "last_updated": "2022-10-06",
        "certification_date": "2022-09-26",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER / MANAGER",
        "authorized_official_telephone_number": "910-202-9113",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3894",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6008801",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cape Fear Developmental Therapies PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cape Fear Developmental Therapies, PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cape Fear Developmental Therapies, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.

Verify at the official NPI Registry.