Melissa Nicole Kirk, R.D., C.D., C.D.E.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DI00000860 Issued in WA

Practice address

1044 11TH Ave
Longview, WA 98632-2506

Phone

(360) 353-9432

Fax

(360) 353-9440

NPI assigned

Dec 8, 2006

Sex

Female

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: mkirk23415@direct.peacehealth.org

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1871652255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2429",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986328486",
            "telephone_number": "360-353-9432",
            "fax_number": "360-353-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 11TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322506",
            "telephone_number": "360-353-9432",
            "fax_number": "360-353-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "MELISSA",
        "middle_name": "NICOLE",
        "credential": "R.D., C.D., C.D.E.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI00000860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8432411",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Autumn Kindvall
• Katana Beth King, ND
• Katie King
• Michelle Myrle Kinney, CPC
• Carol Sue Kircher-Sampson, OTR CHT
• Kyndil Kirkendoll
• Kirkpatrick Family Care
• Kirkpatrick Family Care, PS
• Kirkpatrick Family Care, PS
• Richard Alan Kirkpatrick, M.D.

• Registered Dietitian in Longview, WA
• Providers in Longview, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; 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.