NPIMap

Individual provider Active NPI

Kirk D Sherris, DPM

  • Foot & Ankle Surgery Podiatrist
  • Poulsbo, WA
National Provider Identifier
1710073879
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO0000501 Issued in WA
Practice address
20730 Bond Rd NE Ste 120
Poulsbo, WA 98370-9000
Phone
(360) 434-0539
Fax
(360) 434-0539
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO0000501 WA Primary

Addresses

Primary practice location

20730 Bond Rd NE Ste 120
Poulsbo, WA 98370-9000

Mailing address

PO Box 10206
Bainbridge Island, WA 98110-0206
Phone (360) 434-0539

Other identifiers 1

IdentifierTypeStateIssuer
1080928MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070307000211 WA Practitioner - Podiatry 0840393179 Practice locations: Marysville, WA; Mount Vernon, WA; Orting, WA; Port Angeles, WA; Port Orchard, WA; Port Townsend, WA; Poulsbo, WA; Raymond, WA…
O20200107002409 WA DME Supplier - Physician - Podiatry 6507290152 Practice locations: Poulsbo, WA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19360 Viking Ave NW
Liberty Shores Assisted Living
Poulsbo, WA 98370-7205
Phone (360) 779-5533

204 Gaines St
Port Townsend, WA 98368-6902
Phone (360) 385-6486

20696 Bond Rd NE
Poulsbo, WA 98370-9025

20730 Bond Rd NE
Suite 120
Poulsbo, WA 98370-9000
Phone (360) 434-0539

Hospital & facility affiliations

  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039
  • Jefferson Healthcare Hospital, Port Townsend, WA, CCN 501323

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue2267
Removal or shaving of skin growth233
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO0000501WAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Port Townsend Foot & Ankle Center Foot & Ankle Surgery CurrentSince Sep 3, 2025 Accepting new patients
Port Townsend Foot and Ankle Clinic PS Foot & Ankle Surgery Past Accepting new patients
Yakima Operations LLC Past Accepting new patients
Emeritus Corporation Past Accepting new patients
Preferred Podiatry Group PC Past Accepting new patients
MCP Birchview Wa Opco LLC PastSince Jun 28, 2020 Accepting new patients
Select Rehabilitation, LLC Past Accepting new patients

Locations

204 Gaines St
Port Townsend, WA 98368
Phone (360) 385-6486

20730 Bond Rd NE
Ste 120
Poulsbo, WA 98370
Phone (360) 434-0539

Interoperability endpoints

  • Direct secure messaging: libertybayfootandankle.kirksherris@135678.advancedmd-direct.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1710073879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10206",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981100206",
            "telephone_number": "360-434-0539",
            "fax_number": "877-768-9754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20730 BOND RD NE STE 120",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709000",
            "telephone_number": "360-434-0539",
            "fax_number": "360-434-0539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERRIS",
        "first_name": "KIRK",
        "middle_name": "D",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO0000501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1080928",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

Verify at the official NPI Registry.