Active NPI
Kip H Zirkel, PH.D.
- Clinical Child & Adolescent Psychologist
- La Crosse, WI
National Provider Identifier
1619023090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 781
- Practice address
- 1707 Main St
La Crosse, WI 54601-4200 - Phone
- (608) 785-0001
- Fax
- (608) 785-0002
- NPI assigned
- Jan 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 781 | WI | Primary |
| Forensic Psychologist | 103TF0200X | 781 | WI |
Addresses
Primary practice location
1707 Main St
La Crosse, WI 54601-4200
Mailing address
1707 Main St
La Crosse, WI 54601-4200
Phone (608) 785-0001
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39018600 | Medicaid | WI | |
| HP69927 | Other | HEALTHPARTNERS | |
| 13G9521 | Other | MN | BCBS-MN |
| 31097 | Other | WI | NAT. REGIS. OF H.C. PROV. |
| 852578100 | Medicaid | MN |
Other names 1
- Dr. Clifford Herbert Zirkel III
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
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280361600000",
"number": "1619023090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1707 MAIN ST",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546014200",
"telephone_number": "608-785-0001",
"fax_number": "608-785-0002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1707 MAIN ST",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546014200",
"telephone_number": "608-785-0001",
"fax_number": "608-785-0002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIRKEL",
"first_name": "KIP",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-26",
"last_updated": "2010-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "WI",
"license": "781",
"primary": true
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "WI",
"license": "781",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39018600",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP69927",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS-MN",
"identifier": "13G9521",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NAT. REGIS. OF H.C. PROV.",
"identifier": "31097",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "852578100",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CLIFFORD",
"last_name": "ZIRKEL",
"middle_name": "HERBERT",
"prefix": "DR.",
"suffix": "III",
"credential": "PH.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in La Crosse, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.