NPIMap

Individual provider Active NPI

Lawrence F Kirk Jr., MD

  • Family Medicine Physician
  • Byron, GA
National Provider Identifier
1619962610
Registry record updated Nov 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
042072 Issued in GA
Practice address
200 Highway 49 South
Byron, GA 31008-6937
Phone
(478) 956-2648
Fax
(478) 956-4080
NPI assigned
Sep 15, 2005
Last updated
Nov 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 042072 GA Primary

Addresses

Primary practice location

200 Highway 49 South
Byron, GA 31008-6937

Mailing address

200 Highway 49 South
Byron, GA 31008-6937
Phone (478) 956-2648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050210000390 GA Practitioner - Family PracticePractitioner - Emergency Medicine 6002868791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Mercer University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

200 Ga Hwy 49 S
Byron, GA 31008-6937
Phone 47895626486

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042072GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coliseum Health Group LLC Family Medicine Past Accepting new patients
Health Services of Central Georgia, Inc Family Medicine PastSince Jun 1, 2004 Accepting new patients
Georgia Dental Professionals, PC Past Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients
The Hospital Authority of Monroe County, Georgia Past Accepting new patients

Organizations & group practices 7

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1619962610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HIGHWAY 49 SOUTH",
            "city": "BYRON",
            "state": "GA",
            "postal_code": "310086937",
            "telephone_number": "478-956-2648",
            "fax_number": "478-956-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HIGHWAY 49 SOUTH",
            "city": "BYRON",
            "state": "GA",
            "postal_code": "310086937",
            "telephone_number": "478-956-2648",
            "fax_number": "478-956-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "LAWRENCE",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "042072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Byron, GA

Sources for this page

Verify at the official NPI Registry.