Individual provider Active NPI

Kirk A Powers, P.A.

  • Physician Assistant
  • Westerville, OH
National Provider Identifier
1730492570
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.002993 Issued in OH
Practice address
615 Copeland Mill Rd Ste 2D
Westerville, OH 43081-8904
Phone
(614) 939-2308
Fax
(614) 939-2309
NPI assigned
Jul 22, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.002993 OH Primary

Addresses

Primary practice location

615 Copeland Mill Rd Ste 2D
Westerville, OH 43081-8904

Mailing address

164 Wetherby LN Ste B
Westerville, OH 43081-4957
Phone (614) 939-2308

Other identifiers 1

IdentifierTypeStateIssuer
50.002993RXOtherOHSTATE OF OHIO MEDICAL BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 1, 2023 through Apr 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.002993OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
C G Reddy MD Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1730492570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 WETHERBY LN STE B",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430814957",
            "telephone_number": "614-939-2308",
            "fax_number": "614-939-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 COPELAND MILL RD STE 2D",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430818904",
            "telephone_number": "614-939-2308",
            "fax_number": "614-939-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWERS",
        "first_name": "KIRK",
        "middle_name": "A",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-22",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.002993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF OHIO MEDICAL BOARD",
            "identifier": "50.002993RX",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.