Kathleen E. Irvin, P.A-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0003018 Issued in MD

Practice address

301 Saint Paul St
Baltimore, MD 21202-2165

Phone

(410) 332-9000

NPI assigned

May 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kathleen E. Shea Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kirvin6361@direct.mdmercy.com

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• The Good Samaritan Hospital of Maryland Inc

  • Multi-Specialty Clinic/Center
  • Baltimore, MD
  • NPI 1699796805
  NPD (past)

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1962457580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "address_2": "P.O.B- SUITE G1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392905",
            "telephone_number": "410-532-4730",
            "fax_number": "410-532-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SAINT PAUL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022165",
            "telephone_number": "410-332-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRVIN",
        "first_name": "KATHLEEN",
        "middle_name": "E.",
        "credential": "P.A-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0003018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "SHEA",
            "middle_name": "E.",
            "credential": "P.A-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brenda Iriele
• Emily Irish, CRNA
• Sebastian Cesar Irizarry
• Valerie Ironside, C.R.N.P.
• Alia Irshad, M.D.
• Mikayla Irvin, RDN, LDN
• Nathan A Irvin, M.D.
• Risha Renee' Irvin, M.D.
• Elizabeth Hazebroek Irving, ATC
• John Irwin Jr.

• Physician Assistant in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.