Individual provider Active NPI

Kent Alan Kirchner, M.D.

  • Nephrology Physician
  • Jackson, MS
National Provider Identifier
1629007406
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
08682 Issued in MS
Practice address
1500 E. Woodrow Wilson Blvd
Jackson, MS 39216-5199
Phone
(601) 362-4471
Fax
(601) 364-1456
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 08682 MS Primary

Addresses

Primary practice location

1500 E. Woodrow Wilson Blvd
Jackson, MS 39216-5199

Mailing address

1500 E. Woodrow Wilson Blvd
Jackson, MS 39216-5199
Phone (601) 362-4471

Other identifiers 1

IdentifierTypeStateIssuer
0017455MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130327000204 MS Order and Referring Only - NephrologyPractitioner - Nephrology 3173768959

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629007406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E. WOODROW WILSON BLVD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165199",
            "telephone_number": "601-362-4471",
            "fax_number": "601-364-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E. WOODROW WILSON BLVD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165199",
            "telephone_number": "601-362-4471",
            "fax_number": "601-364-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRCHNER",
        "first_name": "KENT",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MS",
            "license": "08682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017455",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.