Individual provider Active NPI

Allen Scott Kirk, DPM

  • Podiatrist
  • West Milford, NJ
National Provider Identifier
1619078227
Registry record updated Oct 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
MD01471 Issued in NJ
Practice address
1485 Union Valley Rd Ste C
West Milford, NJ 07480-1317
Phone
(973) 728-2211
Fax
(973) 728-2237
NPI assigned
Sep 26, 2006
Last updated
Oct 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X MD01471 NJ Primary

Addresses

Primary practice location

1485 Union Valley Rd Ste C
West Milford, NJ 07480-1317

Mailing address

1485C Union Valley Rd
West Milford, NJ 07480
Phone (973) 728-2211

Other identifiers 1

IdentifierTypeStateIssuer
1097903MedicaidNJ

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
003571NYMDEmergency Medicine Physician
MD01471NJMDPodiatrist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1619078227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485C UNION VALLEY RD",
            "city": "WEST MILFORD",
            "state": "NJ",
            "postal_code": "07480",
            "telephone_number": "973-728-2211",
            "fax_number": "973-728-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 UNION VALLEY RD STE C",
            "city": "WEST MILFORD",
            "state": "NJ",
            "postal_code": "074801317",
            "telephone_number": "973-728-2211",
            "fax_number": "973-728-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "ALLEN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "MD01471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1097903",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Milford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; 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.