Twin Rivers Podiatry of Boyertown

Primary specialty

PodiatristTaxonomy code 213E00000X

License

SC004605L Issued in PA

Legal business name

TWIN RIVERS PODIATRY OF BOYERTOWN

Practice address

5TH and Montgomery
Suite 102
Boyertown, PA 19512-1300

Phone

(610) 367-7000

Fax

(610) 367-4559

NPI assigned

Nov 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Andrew Kirk, DPMNPI 1871686782

Title

Direct Owner

Phone

(610) 367-7000

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in PA2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy A Kirk, DPM

  • Podiatrist
  • Boyertown, PA
  • NPI 1871686782
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1891977088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5TH AND MONTGOMERY",
            "address_2": "SUITE 102",
            "city": "BOYERTOWN",
            "state": "PA",
            "postal_code": "195121300",
            "telephone_number": "610-367-7000",
            "fax_number": "610-367-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5TH AND MONTGOMERY",
            "address_2": "SUITE 102",
            "city": "BOYERTOWN",
            "state": "PA",
            "postal_code": "195121300",
            "telephone_number": "610-367-7000",
            "fax_number": "610-367-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN RIVERS PODIATRY OF BOYERTOWN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "DIRECT OWNER",
        "authorized_official_telephone_number": "610-367-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC004605L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "3126386000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "3126386000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1997171",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50074066",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Boyertown, PA
• Providers in Boyertown, PA by specialty
• Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.