Kirkwood Tanner Shultz, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

3870 Issued in NC

Practice address

19900 W Catawba Ave
Suite C
Cornelius, NC 28031-4032

Phone

(800) 277-8151

NPI assigned

Sep 12, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Diabetic Special Care

  • Endocrinology, Diabetes & Metabolism Physician
  • Cornelius, NC
  • NPI 1104882752
  NPD (past) Authorized official

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199318400000",
    "number": "1760477210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5388",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272625388",
            "telephone_number": "800-277-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19900 W CATAWBA AVE",
            "address_2": "SUITE C",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314032",
            "telephone_number": "800-277-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULTZ",
        "first_name": "KIRKWOOD",
        "middle_name": "TANNER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2008-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NC",
            "license": "3870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8976095",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00095122",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Alan Sherman, RPH
• Pamela Passarelli Sherrill, RD
• Kimiko Shimoda, DIPL. OM, LAC
• Shine & Grow Pediatric Therapy PLLC
• William Bradley Shook, D.C.
• Inga R Siler, MS, CCC-SLP
• Thea Oculato Silva de Souza, PH.D.
• Andrew Link Simpson, LPCA, NCC
• Roy Kelley Sinclair, LPCA
• H'Exote Siu

• Endocrinology, Diabetes & Metabolism Physician in Cornelius, NC
• Providers in Cornelius, NC by specialty
• Endocrinology, Diabetes & Metabolism Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; 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.