1508907445 NPI number — DR. LORI M KIRGIS D.C.

Table of content: DR. LORI M KIRGIS D.C. (NPI 1508907445)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508907445 NPI number — DR. LORI M KIRGIS D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KIRGIS
Provider First Name:
LORI
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
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:
1508907445
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1325 E GREENBRIAR DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA CITY
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46725-8622
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
260-248-2194
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
695 N OPPORTUNITY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA CITY
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46725-1041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
260-244-3665
Provider Business Practice Location Address Fax Number:
260-248-4496
Provider Enumeration Date:
02/12/2007

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: 111N00000X , with the licence number:  08001923A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: P00152264 . This is a "PALMETTO GBA M" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 7676280 . This is a "AETNA" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 0000000334173 . This is a "UNICARE HEALTHCARE PLANS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 2737868 . This is a "ALLIED BENEFITS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200478390A . This is a "MANAGED HEALTH SERVICE IN" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200325660 . This is a "MANAGED HEALTH SERVICE IN" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000334173 . This is a "IN BLUE SHIELD ANTHEM" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200325660 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 214620 . This is a "UNICARE PFFS CLAIMS DEPT" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 214620A . This is a "HUMANA CLAIMS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200325660 . This is a "HARMONY HEALTH PLAN" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 214620A . This is a "MEDICARE COMPLETE ESSENTI" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 214620A . This is a "SECURE HORIZONS DIRECT" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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