Individual provider Active NPI

Anthony James Kirkby, LPN

  • Licensed Practical Nurse
  • Wadsworth, OH
National Provider Identifier
1679722573
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN126061 Issued in OH
Practice address
122 W Bergey St
Wadsworth, OH 44281-1329
Phone
(216) 408-0057
NPI assigned
Sep 16, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN126061 OH Primary

Addresses

Primary practice location

122 W Bergey St
Wadsworth, OH 44281-1329

Mailing address

122 W Bergey St
Wadsworth, OH 44281-1329
Phone (216) 408-0057

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN126061OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221523200000",
    "number": "1679722573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W BERGEY ST",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442811329",
            "telephone_number": "216-408-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 W BERGEY ST",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442811329",
            "telephone_number": "216-408-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKBY",
        "first_name": "ANTHONY",
        "middle_name": "JAMES",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-16",
        "last_updated": "2008-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN126061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadsworth, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.