Kirk G Andrus MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G34543 Issued in CA

Legal business name

KIRK G ANDRUS MD

Practice address

4135 Main St
Kelseyville, CA 95451-8941

Phone

(707) 279-2004

Fax

(707) 279-2832

NPI assigned

Nov 8, 2007

Last updated

Jan 5, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kirk G Andrus, MDNPI 1699789891

Title

Owner

Phone

(707) 279-2204

Specialties & licenses 1

Addresses

Other names 1

• Kelseyville Family Practice Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kirk G Andrus, MD

  • Family Medicine Physician
  • Kelseyville, CA
  • NPI 1699789891
  Authorized official Same address or phone

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231113600000",
    "number": "1700066529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 MAIN ST",
            "city": "KELSEYVILLE",
            "state": "CA",
            "postal_code": "954518941",
            "telephone_number": "707-279-2204",
            "fax_number": "707-279-2832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 MAIN ST",
            "city": "KELSEYVILLE",
            "state": "CA",
            "postal_code": "954518941",
            "telephone_number": "707-279-2004",
            "fax_number": "707-279-2832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRK G ANDRUS MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2009-01-05",
        "status": "A",
        "authorized_official_last_name": "ANDRUS",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-279-2204",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G34543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kelseyville Family Practice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Claire Johnson
• Eileen R Kalk, PA
• Pearly Pearly Karunakaran
• Kelseyville Fire Protection District
• Kelseyville Unified School District
• Heather Kristine Kriken, LCSW
• Lake County Office of Education
• Lake County Office of Education
• Lake County Office of Education
• Lake County Office of Education

• Family Medicine Physician in Kelseyville, CA
• Providers in Kelseyville, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2009; 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.