Individual provider Active NPI

James William Kirk, D.C.

  • Chiropractor
  • Odessa, TX
National Provider Identifier
1891856514
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5928 Issued in TX
Practice address
2458 E 11TH St
Odessa, TX 79761-4236
Phone
(432) 337-5553
Fax
(432) 337-6183
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5928 TX Primary

Addresses

Primary practice location

2458 E 11TH St
Odessa, TX 79761-4236

Mailing address

2458 E 11TH St
Odessa, TX 79761-4236
Phone (432) 337-5553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090318000576 TX Practitioner - Chiropractic 1254498256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1992
Medicare assignment
May accept Medicare assignment
Group practices
Clark Chiropractic ClinicGroup PAC ID 2365509379, 6 clinicians

Practice addresses (Care Compare)

6301 Eastridge Rd
Odessa, TX 79762-5045
Phone (432) 337-5553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clark Chiropractic Clinic Chiropractor CurrentSince Jul 23, 2008 Accepting new patients

Locations

6301 Eastridge Rd
Odessa, TX 79762
Phone (432) 337-5553

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1891856514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2458 E 11TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614236",
            "telephone_number": "432-337-5553",
            "fax_number": "432-337-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2458 E 11TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614236",
            "telephone_number": "432-337-5553",
            "fax_number": "432-337-6183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "JAMES",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "5928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.