Individual provider Active NPI

Brandy Alicia Kirk, FNP-BC

  • Nurse Practitioner
  • Michigan City, IN
National Provider Identifier
1679234009
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71012078A Issued in IN
Practice address
1 Park Row St
Michigan City, IN 46360-6597
Phone
(219) 874-7256
Fax
(219) 879-9839
NPI assigned
Jan 7, 2022
Last updated
Jan 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71012078A IN Primary

Addresses

Primary practice location

1 Park Row St
Michigan City, IN 46360-6597

Mailing address

8837 Carolina Ave
Highland, IN 46322-2115
Phone (219) 742-4005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220425000950 IN Practitioner - Nurse Practitioner 5991192825 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Smart Physician Systems PCGroup PAC ID 3678853645, 8 clinicians

Practice addresses (Care Compare)

10176 W 400
Suite C
Michigan City, IN 46360-9009
Phone (219) 873-1777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Mary Tilak PC CurrentSince Jun 1, 2022 Accepting new patients
Smart Physician Systems PC CurrentSince Jan 1, 2026 Accepting new patients
The Methodist Hospitals, Inc CurrentSince Jun 1, 2024 Accepting new patients
The Methodist Hospitals, Inc CurrentSince Jun 1, 2024 Accepting new patients
Cardiovascular Consultants PC Past Accepting new patients
The Methodist Hospitals, Inc. Past Accepting new patients

Locations

27350 Network Pl
Chicago, IL 60673

1275 E North St
Crown Point, IN 46307
Phone (219) 663-2793

1275 E North St
Ste 102
Crown Point, IN 46307
Phone (219) 922-8051

6625 W US Highway 30
Crown Point, IN 46307
Phone (219) 440-5360

2241 45th St
Highland, IN 46322
Phone (219) 738-1736

200 E 89th Ave
Merrillville, IN 46410
Phone (219) 738-4926

8102 Georgia St
#1
Merrillville, IN 46410
Phone (219) 595-0300

8701 Broadway
Merrillville, IN 46410
Phone (219) 738-4926

10176 W 400 N
Ste C
Michigan City, IN 46360
Phone (219) 873-1777

8242 Calumet Ave
Ste 1
Munster, IN 46321
Phone (219) 595-0300

9410 Calumet Ave
Ste 101
Munster, IN 46321
Phone (219) 922-8051

Interoperability endpoints

  • Direct secure messaging: bkirk136418@themethodisthospitals.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/CBEIBA

Organizations & group practices 6

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 6

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": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1679234009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8837 CAROLINA AVE",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463222115",
            "telephone_number": "219-742-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARK ROW ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463606597",
            "telephone_number": "219-874-7256",
            "fax_number": "219-879-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "BRANDY",
        "middle_name": "ALICIA",
        "name_prefix": "Miss",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-07",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71012078A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.