Individual provider Active NPI

Wayne Franklin Kirk, DC

  • Chiropractor
  • Evansville, IN
National Provider Identifier
1720032188
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001920A Issued in IN
Practice address
2333 Washington Ave.
Evansville, IN 47714-2349
Phone
(812) 477-5201
Fax
(812) 477-5293
NPI assigned
May 20, 2006
Last updated
Aug 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08001920A IN Primary

Addresses

Primary practice location

2333 Washington Ave.
Evansville, IN 47714-2349

Mailing address

2333 Washington Ave.
Evansville, IN 47714-2349
Phone (812) 477-5201

Other identifiers 3

IdentifierTypeStateIssuer
200279220AMedicaidIN
350053694OtherINRAILROAD MEDICARE
000000112035OtherINANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110113000123 IN Practitioner - Chiropractic 2062601644 Practice locations: Evansville, IN

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1222 A Professional Blvd
Evansville, IN 47714-8002
Phone (812) 477-5201

1222 Professional Blvd
Suite a
Evansville, IN 47714-8002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1720032188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 WASHINGTON AVE.",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477142349",
            "telephone_number": "812-477-5201",
            "fax_number": "812-477-5293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 WASHINGTON AVE.",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477142349",
            "telephone_number": "812-477-5201",
            "fax_number": "812-477-5293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "WAYNE",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001920A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200279220A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350053694",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000112035",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.