1215957006 NPI number — DR. SARAH JANE KIRKSEY AU.D., CCC-A, FAAA

Table of content: DR. SARAH JANE KIRKSEY AU.D., CCC-A, FAAA (NPI 1215957006)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215957006 NPI number — DR. SARAH JANE KIRKSEY AU.D., CCC-A, FAAA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KIRKSEY
Provider First Name:
SARAH
Provider Middle Name:
JANE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
AU.D., CCC-A, FAAA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215957006
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
346 BOOTH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GAITHERSBURG
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20878-5475
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-208-8674
Provider Business Mailing Address Fax Number:
301-946-2435

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3913 FERRARA DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SILVER SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20906-4709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-946-2434
Provider Business Practice Location Address Fax Number:
301-946-2435
Provider Enumeration Date:
07/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  692 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 231HA2400X , with the licence number: 692 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231HA2500X , with the licence number: 692 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237600000X , with the licence number: 692 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 241011 . This is a "ALLIANCE PPO PROV ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 69281 . This is a "AMERIGROUP PROVIDER ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 20420001 . This is a "BLUECHOICE ID NUMBER" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 484823 . This is a "NCPPO GROUP NUMBER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: L332HE . This is a "BCBS OF MD ALT. GROUP ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 20420001 . This is a "BCBS OF DC PROV ID" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 09500100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 521981246001 . This is a "CIGNA PROVIDER ID NUMBER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: KIRKSEY . This is a "INOVA PROVIDER ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0995983 . This is a "AETNA PROVIDER ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 241011 . This is a "MAMSI PROVIDER ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 521981246 . This is a "MEDICARE FIRST GROUP NUMB" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: L117HE . This is a "BCBS OF MD GROUP ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 116338 . This is a "KAISER PERM. GROUP NUMBER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 2042 . This is a "BCBS OF DC GROUP NUMBER" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 241011 . This is a "MDIPA PROVIDER ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com