Kirby Carlson

Key facts

NPI

1942970348

Entity type

Individual (NPI type 1)

Primary specialty

Nurse Practitioner 363L00000X

License

71011727A (IN)

Practice address

11108 Parkview Circle Dr
Fort Wayne, IN 46845-1730

Phone

(260) 266-5700

Fax

(260) 266-5910

NPI assigned

Sep 16, 2021

Sex

Male

Sole proprietor

No

Organizations & group practices 2

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.

• Parkview Health System Inc Family Medicine Physician · Fort Wayne, IN · NPI 1932130952
  Medicare reassignment Care Compare group NPD IN · NURSE PRACTITIONER
• Parkview Health System, Inc. Cardiovascular Disease Physician · Fort Wayne, IN · NPI 1447585153
  Care Compare group NPD NURSE PRACTITIONER

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community Hospital of Lagrange County Inc Critical Access Hospital · Lagrange, IN · NPI 1679674956
  Care Compare affiliation Hospital
• Community Hospital of Noble County, Inc. General Acute Care Hospital · Kendallville, IN · NPI 1457366189
  Care Compare affiliation Hospital
• Dekalb Memorial Hospital, Inc General Acute Care Hospital · Auburn, IN · NPI 1902897937
  Care Compare affiliation Hospital
• Parkview Hospital, Inc. General Acute Care Hospital · Fort Wayne, IN · NPI 1366407603
  Care Compare affiliation Hospital
• Whitley Memorial Hospital, Inc. General Acute Care Hospital · Columbia City, IN · NPI 1205844495
  Care Compare affiliation Hospital
• Whitley Memorial Hospital, Inc. Land Ambulance · Columbia City, IN · NPI 1497764450
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Parkview Health System Inc (1,350 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkview Regional Medical Center Hospital · Fort Wayne, IN · CCN 150021
• Parkview Whitley Hospital Hospital · Columbia City, IN · CCN 150101
• Parkview Dekalb Hospital Hospital · Auburn, IN · CCN 150045
• Parkview Noble Hospital Hospital · Kendallville, IN · CCN 150146
• Parkview Lagrange Hospital Hospital · Lagrange, IN · CCN 151323

Merit-based Incentive Payment System (MIPS)

Final score

83.53 of 100 (group)

Quality

70

Promoting interoperability

100

Improvement activities

40

Cost

75.11

Medicare participation

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kcarlson474562@direct.parkviewexchange.com

Specialties & licenses

Addresses

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 17, 2022.

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1942970348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11108 PARKVIEW CIRCLE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451730",
            "telephone_number": "260-266-5700",
            "fax_number": "260-266-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "KIRBY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-16",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71011727A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcarlson474562@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "11108 Parkview Circle Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451730",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "11108 Parkview Circle Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451730",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "11108 Parkview Circle Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

• Christopher Carlin, R-PAC
• Cynthia Joell Carlin, FNP-C
• Aniya Carlisle
• Danielle Lauren Carlson, CRNA
• Ina S. Carlson, PH.D., HSPP
• Tabitha A Carlson, PSYD
• Trina Carlson
• Connie Carman, LCSW, LCAC
• Kyleigh Carmean, RBT
• Madison Carmean

All providers in Fort Wayne, IN · Nurse Practitioner in Indiana