Kathleen Mary Kirwin, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

002756 Issued in CT

Practice address

116 S Main St
The Carriage House
Wallingford, CT 06492-4217

Phone

(203) 697-0807

Fax

(203) 265-3651

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathleen.kirwin.p1@direct.wheelerclinic.nextgenshare.com

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.

• Wheeler Clinic Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Plainville, CT
  • NPI 1396750840
  Medicare reassignment NPD
• Wheeler Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Bristol, CT
  • NPI 1790532802
  NPD
• Peaceful Psychiatry, LLC

  • Community/Behavioral Health Agency
  • Wallingford, CT
  • NPI 1912594268
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1598797862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 S MAIN ST",
            "address_2": "THE CARRIAGE HOUSE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064924217",
            "telephone_number": "203-697-0807",
            "fax_number": "203-265-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S MAIN ST",
            "address_2": "THE CARRIAGE HOUSE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064924217",
            "telephone_number": "203-697-0807",
            "fax_number": "203-265-3651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRWIN",
        "first_name": "KATHLEEN",
        "middle_name": "MARY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "002756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3248477",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "5600002756CT2",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tuba Khawaja, MD
• Sarah Jane Kilian, APRN
• Ashlie Santine Kipperman, PT, DPT
• Aaditya Kiri, MD
• Jason Stuart Kirk, PT
• Sarah Kleven
• Leonard A Kolstad, M.D.
• Debbra Konopaske, PTA
• Tyler Konopka
• Judy Robin Kopman-Fried, LCSW

• Psychiatric/Mental Health Nurse Practitioner in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.