Bertha Renee Kirwan, FNP, MSN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

12637 Issued in OH

Practice address

332 Congress Park Dr
Dayton, OH 45459-4133

Phone

(937) 312-3627

NPI assigned

Sep 22, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Circleville Emergency Physicians Inc.

  • Emergency Medicine Physician
  • Circleville, OH
  • NPI 1770583833
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1639452006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6845 WORTHINGTON GALENA RD",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430852645",
            "telephone_number": "614-847-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 CONGRESS PARK DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594133",
            "telephone_number": "937-312-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRWAN",
        "first_name": "BERTHA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "FNP, MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "12637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "313697",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING, COA",
            "identifier": "12637",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacey Kirksey
• Kirkwood Family Practice, LLC
• David Charles Kirkwood, M.D.
• Karen Elaine Kirpaul, DPM
• David Louis Kirschman, MD
• Annika Frances Kisha, MD
• John F Kissinger
• Laura Kitchel
• Shelby Autumn Kitchin, MD
• Melissa Ruth Kite, PA-C

• Family Nurse Practitioner in Dayton, OH
• Providers in Dayton, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.