Active NPI
Jeffrey Kirk, LPN
- Licensed Practical Nurse
- Charleston, WV
National Provider Identifier
1740907591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 20549
- Practice address
- 400 Tracy Way
Charleston, WV 25311-1280 - Phone
- (304) 720-0205
- NPI assigned
- Oct 24, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 20549 | WV | Primary |
Addresses
Primary practice location
400 Tracy Way
Charleston, WV 25311-1280
Mailing address
400 Tracy Way
Charleston, WV 25311-1280
Phone (302) 720-0205
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Desktop/tablet |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666569600000",
"number": "1740907591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 TRACY WAY",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253111280",
"telephone_number": "302-720-0205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 TRACY WAY",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253111280",
"telephone_number": "304-720-0205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRK",
"first_name": "JEFFREY",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-24",
"last_updated": "2022-10-24",
"certification_date": "2022-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "WV",
"license": "20549",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Desktop/tablet",
"affiliation": "N",
"address_1": "400 Tracy Way",
"city": "Charleston",
"state": "WV",
"country_code": "US",
"postal_code": "253111280",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.