Active NPI
Kent Alan Kirchner, M.D.
- Nephrology Physician
- Jackson, MS
National Provider Identifier
1629007406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 08682
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0017455 | Medicaid | MS |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130327000204 | MS | Order and Referring Only - 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.