Individual provider Active NPI

Kenneth Kirkman, M.D.

  • Family Medicine Physician
  • Terre Haute, IN
National Provider Identifier
1740305143
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01043002A Issued in IN
Practice address
3387 S US Highway 41
Terre Haute, IN 47802-4188
Phone
(812) 232-5532
Fax
(812) 232-2574
NPI assigned
Mar 21, 2007
Last updated
Jun 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01043002A IN Primary
Occupational Medicine Physician 2083X0100X 01043002A IN

Addresses

Primary practice location

3387 S US Highway 41
Terre Haute, IN 47802-4188

Mailing address

3387 S US Highway 41 Ste 1200
Terre Haute, IN 47802-4188
Phone (812) 232-5532

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110623000634 IN Practitioner - Family Practice 9436337334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ambucare ClinicGroup PAC ID 3476445081, 7 clinicians

Practice addresses (Care Compare)

3387 S US Hwy 41
Terre Haute, IN 47802-3727
Phone (812) 232-5532

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01043002AINMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ambucare Clinic Family Medicine CurrentSince Jun 1, 2011 Accepting new patients
Major Hospital Past Accepting new patients
Susan Koslow M.D.,Inc PastSince Jun 1, 2011 Accepting new patients
Deaconess Hospital Inc Past Accepting new patients

Locations

3387 S US Highway 41
Terre Haute, IN 47802
Phone (812) 232-5532

3387 S US Highway 41
Ste 1200
Terre Haute, IN 47802

Organizations & group practices 4

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

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1740305143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3387 S US HIGHWAY 41 STE 1200",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024188",
            "telephone_number": "812-232-5532",
            "fax_number": "812-232-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3387 S US HIGHWAY 41",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024188",
            "telephone_number": "812-232-5532",
            "fax_number": "812-232-2574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKMAN",
        "first_name": "KENNETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01043002A",
            "primary": true
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "IN",
            "license": "01043002A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.