Active NPI
Joel Donnel Kirkland Sr.
- Adult Companion
- New Haven, CT
National Provider Identifier
1700380706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- License
- HCA.0001408
- Practice address
- 30 Brewster St
New Haven, CT 06511-1804 - Phone
- (203) 800-6144
- NPI assigned
- Mar 22, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Companion | 372600000X | HCA.0001408 | CT | Primary |
Addresses
Primary practice location
30 Brewster St
New Haven, CT 06511-1804
Mailing address
30 Brewster St
New Haven, CT 06511-1804
Phone (203) 800-6144
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HCA.0001408 | Medicaid | CT | |
| 43095686-000 | Other | CT | CONSUMER PROTECTION |
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
| License | State | Type | Specialty |
|---|---|---|---|
| HCA.0001408 | CT | MD | Adult Companion |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521676800000",
"number": "1700380706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 BREWSTER ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065111804",
"telephone_number": "203-800-6144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 BREWSTER ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065111804",
"telephone_number": "203-800-6144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRKLAND",
"first_name": "JOEL",
"middle_name": "DONNEL",
"name_suffix": "Sr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-03-22",
"last_updated": "2018-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Adult Companion",
"state": "CT",
"license": "HCA.0001408",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "HCA.0001408",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONSUMER PROTECTION",
"identifier": "43095686-000",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.