Active NPI
Jamie Ellen Kirby, M.D.
- Family Medicine Physician
- Tyler, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- P3179
- Practice address
- 5414 S Broadway Ave
Tyler, TX 75703-1335 - Phone
- (903) 581-1601
- NPI assigned
- Feb 2, 2007
- Last updated
- Oct 3, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0433607 | KS | |
| Family Medicine Physician | 207Q00000X | P3179 | TX | Primary |
Addresses
Primary practice location
5414 S Broadway Ave
Tyler, TX 75703-1335
Mailing address
PO Box 841656
Dallas, TX 75284-1656
Phone (903) 531-5000
Other practice location 1
719 W Coke Rd Ste 3
Winnsboro, TX 75494-3060
Phone (903) 342-3760
Other practice location 2
2101 W Loop 281
Longview, TX 75604-2506
Phone (903) 315-4180
Other identifiers 17
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 302017403 | Medicaid | TX | |
| 8EZ110 | Other | TX | BCBS |
| 75-1976930-005 | Other | TX | TRICARE |
| 750818167002 | Other | TX | TRICARE |
| P01876970 | Other | TX | MEDICARE RAIL ROAD |
| 8DG764 | Other | TX | BCBS |
| 8EZ029 | Other | TX | BCBS |
| 00T71U | Other | TX | BCBS BLUE |
| 297758YS6V | Other | TX | MEDICARE |
| 75-2616977-028 | Other | TX | TRICARE |
| 75-2616977 | Other | TX | RAIL ROAD |
| 75-2616977-001 | Other | TX | TRICARE |
| 75-2616977-002 | Other | TX | TRICARE |
| 75-2616977-118 | Other | TX | TRICARE |
| 302017401 | Medicaid | TX | |
| 302017402 | Medicaid | TX | |
| P01081606 | Other | TX | RAIL ROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DCS Medical PA | Current | Accepting new patients | |
| Williams Medical Group Practice, LLC | Current | Accepting new patients | |
| DCS Medical PA | Current | Accepting new patients | |
| Christus Trinity Clinic Texas | Family Medicine | Current | Accepting new patients |
| Williams Medical Group Practice, LLC | Family Medicine | Current | Accepting new patients |
| Mother Frances Hospital Regional Health Care Center | Current | Accepting new patients | |
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Mother Frances Hospital Jacksonville | Current | Accepting new patients |
Locations
1817 Arlington St
Ada, OK 74820
Phone (580) 279-0985
901 W Main St
Durant, OK 74701
Phone (580) 634-2931
220 S Van Buren St
Enid, OK 73703
Phone (580) 234-9355
777 NW 63rd St
Fl 2
Oklahoma City, OK 73116
1115 E Tyler St
Athens, TX 75751
Phone (903) 292-5015
3201 University Dr E
Ste 135
Bryan, TX 77802
Phone (979) 703-1832
2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500
2101 W Loop 281
Longview, TX 75604
Phone (903) 315-4180
5414 S Broadway Ave
Tyler, TX 75703
Phone (903) 581-1601
630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888
800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018
719 W Coke Rd
Ste 3
Winnsboro, TX 75494
Phone (903) 342-3376
Interoperability endpoints
- jamie.kirby@22735065448452.direct.elationemr.com
- jkirby17142@christushealth.direct-ci.net
Organizations & group practices 8
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.
-
dba Christus Trinity Clinic
- Family Medicine Physician
- Tyler, TX
- NPI 1285684225
-
dba CHRISTUS Mother Frances Hospital - Jacksonville
- Critical Access Hospital
- Jacksonville, TX
- NPI 1952306672
-
dba Christus Mother Frances Hospital Tyler
- General Acute Care Hospital
- Tyler, TX
- NPI 1679578439
-
dba Integrity Urgent Care
- Family Medicine Physician
- Lawton, OK
- NPI 1346608809
-
dba Christus Trinity Clinic
- Rural Health Clinic/Center
- Winnsboro, TX
- NPI 1801673165
-
dba Integrity Urgent Care
- Rural Health Clinic/Center
- Collinsville, OK
- NPI 1215751508
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696291200000",
"number": "1699813378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 841656",
"city": "DALLAS",
"state": "TX",
"postal_code": "752841656",
"telephone_number": "903-531-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5414 S BROADWAY AVE",
"city": "TYLER",
"state": "TX",
"postal_code": "757031335",
"telephone_number": "903-581-1601"
}
],
"practiceLocations": [
{
"address_1": "719 W Coke Rd Ste 3",
"address_purpose": "LOCATION",
"city": "Winnsboro",
"state": "TX",
"postal_code": "754943060",
"country_code": "US",
"telephone_number": "903-342-3760",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2101 W Loop 281",
"address_purpose": "LOCATION",
"city": "Longview",
"state": "TX",
"postal_code": "756042506",
"country_code": "US",
"telephone_number": "903-315-4180",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIRBY",
"first_name": "JAMIE",
"middle_name": "ELLEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-02",
"last_updated": "2023-10-03",
"certification_date": "2023-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "0433607",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "P3179",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "302017403",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8EZ110",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "75-1976930-005",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "750818167002",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAIL ROAD",
"identifier": "P01876970",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8DG764",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8EZ029",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS BLUE",
"identifier": "00T71U",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "297758YS6V",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "75-2616977-028",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD",
"identifier": "75-2616977",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "75-2616977-001",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "75-2616977-002",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "75-2616977-118",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "302017401",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "302017402",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD",
"identifier": "P01081606",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.