Christian Kirk

Primary specialty

PharmacistTaxonomy code 183500000X

License

PST.024494 Issued in LA

Practice address

105 W Highway 30
Gonzales, LA 70737-4802

Phone

(225) 644-0434

NPI assigned

Sep 20, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Walgreen Co.

  • Pharmacy
  • Gonzales, LA
  • NPI 1134318132
  NPD
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1750004214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8104 ANTEBELLUM AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708205303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W HIGHWAY 30",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707374802",
            "telephone_number": "225-644-0434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "CHRISTIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PST.024494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "PST.024494",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Walgreens",
            "affiliation": "N",
            "address_1": "105 W Highway 30",
            "city": "Gonzales",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707374802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sharon B Kernan, RN
• Deidre G Kibbe, LCSW
• Darla Lynn Kiffe, WHNP-BC
• Bradley James Killebrew, DDS
• William Bradley Kimbrough III, M.D.
• Amy Lynette Kisner, MD
• Scott Clayton Kogler
• Komprehensive Transportation
• Kathryn Rae Kortering, DC
• Amanda Elyse Krysiak, DDS

• Pharmacist in Gonzales, LA
• Providers in Gonzales, LA by specialty
• Pharmacist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.

Verify at the official NPI Registry.