Roger Wayne Kirk Jr., CRNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1-079245 Issued in AL

Practice address

1340 Highway 231 S Ste 1
Troy, AL 36081-3012

Phone

(334) 770-7337

Fax

(334) 770-7339

NPI assigned

Jul 1, 2008

Last updated

Feb 17, 2012By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in AL

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.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Alabama School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dothan Pediatric Clinic, P. a.Group PAC ID 0749245330, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rogerkirk@dpc.allscriptsdirect.net

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.

• Dothan Pediatric Clinic, P. a.

  • Pediatrics Physician
  • Dothan, AL
  • NPI 1376508788
  Medicare reassignment Care Compare group NPD
• Emedical Group Inc

  dba ePediatrics and Family Care

  • Rural Health Clinic/Center
  • Union Springs, AL
  • NPI 1912203712
  NPD (past)

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1790947620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 312",
            "city": "UNION SPRINGS",
            "state": "AL",
            "postal_code": "360890312",
            "telephone_number": "334-740-5252",
            "fax_number": "334-738-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 HIGHWAY 231 S STE 1",
            "city": "TROY",
            "state": "AL",
            "postal_code": "360813012",
            "telephone_number": "334-770-7337",
            "fax_number": "334-770-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "ROGER",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-01",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-079245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renie Kennedy
• Keystone Hospitalist Services of Alabama, Inc.
• Keystone Medical Services of Alabama, Inc.
• Lauren D. Kilcrease, RN, FNP-BC
• Mercedes Jones Kilcrease, PA-C
• Olivia Grace Kirkpatrick
• Brooke Kleinschmidt, LAT, ATC
• Kassidy Morgan Knight
• Lakeyta Tamieka Knight, LMSW
• Latesha Michelle Knight, LPC

• Pediatric Nurse Practitioner in Troy, AL
• Providers in Troy, AL by specialty
• Pediatric Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.