Nicole Alexis Kirby, RCCS, RCS, RPHS, RVS

Primary specialty

Cardiovascular-Interventional Technology Radiologic TechnologistTaxonomy code 2471C1101X

License

00069422 Issued in NU

Practice address

3962 Derby Glen Dr
Clermont, FL 34711-4608

Phone

(813) 789-5975

NPI assigned

Aug 26, 2022

Last updated

Aug 26, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1639898000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3962 DERBY GLEN DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347114608",
            "telephone_number": "813-789-5975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3962 DERBY GLEN DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347114608",
            "telephone_number": "813-789-5975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "NICOLE",
        "middle_name": "ALEXIS",
        "credential": "RCCS, RCS, RPHS, RVS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-26",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "FL",
            "license": "00069422",
            "primary": false
        },
        {
            "code": "2471C1101X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Cardiovascular-Interventional Technology",
            "state": "NU",
            "license": "00069422",
            "primary": true
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "NU",
            "license": "00069422",
            "primary": false
        },
        {
            "code": "2471V0105X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": "NU",
            "license": "00069422",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Kilhullen- Rascati
• Paul Kim, MD
• Kinder Konsulting & Parents Too, Inc.
• Kinder Konsulting & Parents Too, Inc.
• Samara King, MSOTR/L
• Linda Kay Kirkpatrick, NP
• Tanya Kirpalani, PA-C
• Timothy H Klein, ARNP
• Shelly Lyn Klosterman, MS,CCC-SLP
• Laura Lee Klotz, L.AC

• Radiologic Technologist in Clermont, FL
• Providers in Clermont, FL by specialty
• Radiologic Technologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; 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.