Individual provider Active NPI

John Smith Kirkland Jr., MD

  • Vascular Surgery Physician
  • Rome, GA
National Provider Identifier
1801958772
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
015480 Issued in GA
Practice address
796 N Division St NW
Rome, GA 30165-1404
Phone
(762) 235-3760
Fax
(706) 232-4131
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 015480 GA Primary

Addresses

Primary practice location

796 N Division St NW
Rome, GA 30165-1404

Mailing address

221 Technology Pkwy NW
Rome, GA 30165-1369
Phone (762) 235-1000

Other identifiers 2

IdentifierTypeStateIssuer
000155438AMedicaidGA
000155438GMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address john.kirkland.1@1498.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20040916000646 GA Practitioner - Vascular Surgery 3476520594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Emory University School of Medicine, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harbin Clinic LLCGroup PAC ID 0446154231, 238 clinicians

Practice addresses (Care Compare)

796 N Division St NW
Rome, GA 30165-1404
Phone (762) 235-3760

Hospital & facility affiliations

  • Atrium Health Floyd Medical Center Hospital, Rome, GA, CCN 110054

Merit-based Incentive Payment System (MIPS)

Final score
83.23 of 100Reported as group
Quality
65.74
Promoting interoperability
100
Improvement activities
40
Cost
78.37

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal26

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harbin Clinic, LLC Current Accepting new patients
Harbin Clinic, LLC CurrentSince Jul 1, 1966 Accepting new patients
Harbin Clinic, LLC CurrentSince Jul 1, 1966 Accepting new patients

Locations

14 Cherokee Rd
Cedartown, GA 30125
Phone (770) 748-2567

221 Technology Pkwy NW
Rome, GA 30165
Phone (762) 235-1000

796 N Division St NW
Rome, GA 30165
Phone (762) 235-3760

1825 Martha Berry Blvd NW
Rome, GA 30165
Phone (706) 238-8073

Interoperability endpoints

  • Direct secure messaging: jkirkland1001811@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: john.kirkland.1@1498.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1801958772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 TECHNOLOGY PKWY NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651369",
            "telephone_number": "762-235-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "796 N DIVISION ST NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651404",
            "telephone_number": "762-235-3760",
            "fax_number": "706-232-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKLAND",
        "first_name": "JOHN",
        "middle_name": "SMITH",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "015480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000155438A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000155438G",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "john.kirkland.1@1498.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "796 N Division St NW",
            "city": "Rome",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301651404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.