WALTER R KIRBY (NPI# 1649414905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649414905 |
| Entity Type | Individual |
| Full Name | WALTER R KIRBY |
| Credential | PA-C |
| Practice Address |
333 Revolutionary Trl Fairfax SC 29827-7109 |
| Mailing Address |
86 Wren St Barnwell SC 29812-1529 |
| Practice Telephone | 8036322533 |
| Practice Fax Number | 8036322451 |
| Mailing Telephone | 8032595762 |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2017-11-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 2214 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 2119PA | 05 |
| Street Address |
333 REVOLUTIONARY TRL |
| City | FAIRFAX |
| State | SC |
| Zip Code | 29827-7109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033160254 | Baxter Mclendon | Specialist | 333 Revolutionary Trl, Fairfax, SC 29827-7109 | 2006-05-12 |
| 1851656243 | Wanda W Tutt | Dietitian, Registered | 333 Revolutionary Trl, Fairfax, SC 29827-7109 | 2012-07-11 |
| 1104979061 | Delois Daniels | Nurse Practitioner | 333 Revolutionary Trl, Fairfax, SC 29827-7109 | 2007-01-22 |
| 1164516209 | Bobbie Franklin Ayers Jr. | Family Medicine | 333 Revolutionary Trl, Fairfax, SC 29827-7109 | 2006-10-03 |
| 1538170121 | Lucille Miley Sanders | Nurse Practitioner | 333 Revolutionary Trl, Fairfax, SC 29827-7109 | 2006-08-10 |
| 1003820531 | Richard Boyles | Family Medicine | 333 Revolutionary Trl, Fairfax, SC 29827-7109 | 2006-07-28 |
| 1407878366 | Janet M Mckissick | Family Medicine | 333 Revolutionary Trl, Fairfax, SC 29827-7109 | 2006-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467843078 | We Care Family Resource LLC | Point of Service | 513 Bayshore Dr., Fairfax, SC 29827 | 2015-02-18 |
| 1154606440 | Robert M. Haberkorn Dds | Clinic/Center | 1987 Allendale Fairfax Hwy., Fairfax, SC 29827 | 2011-10-18 |
| 1144370503 | Allendale County Hospital Board | Clinic/Center | 1787 Allendale Fairfax Highway, Fairfax, SC 29827 | 2007-01-10 |
| 1336246677 | Allendale County Hospital Board | Skilled Nursing Facility | 185 Revolutionary Trail, Fairfax, SC 29827 | 2006-09-20 |
| 1881646669 | Shenika L. Marshall-hill | Counselor | 1594 Beaufort Ave. S., Fairfax, SC 29827 | 2006-05-17 |
| 1588623540 | Rebecca Lynn Wilkes | Nurse Practitioner | 333 Revolutionary Trail, Fairfax, SC 29827 | 2006-03-20 |
| 1497745012 | Robert M Haberkorn | Dentist | 1987 Allendale-fairfax Hwy, Fairfax, SC 29827 | 2005-10-25 |
| 1588815021 | James Robert Mynatt | Nurse Practitioner | 333 Revolutionary Trail, Fairfax, SC 29827 | 2008-10-02 |
| 1063607646 | Mol Ky | General Practice | 333 Revolutionary Trail, Fairfax, SC 29827 | 2007-09-07 |
| 1053475566 | Low Country Health Care System, Inc | Pharmacy | 333 Revolutionary Trail, Farifax, SC 29827 | 2006-12-20 |
| Find all providers in zip 29827 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053894493 | Natasha Olliver | Physician Assistant | 8500 Executive Park Ave Ste 200, Fairfax, VA 22031-2228 | 2018-09-12 |
| 1932681376 | Joanne Towers | Physician Assistant | 3025 Hamaker Court Suite 300, Fairfax, VA 22031 | 2018-09-01 |
| 1013493451 | Elizabeth Joan Dwyer | Physician Assistant | 3023 Hamaker Ct., Suite 500, Fairfax, VA 22031 | 2018-07-18 |
| 1831692375 | Lauren Mackenzie Mason | Physician Assistant | 3959 Pender Dr Ste 100, Fairfax, VA 22030-6041 | 2018-03-12 |
| 1164949665 | Kaitlyn Burns | Physician Assistant | 3700 Joseph Siewick Dr Ste 404, Fairfax, VA 22033-1745 | 2017-08-25 |
| 1699299628 | Mona Yazdani | Physician Assistant | 2920 District Ave Apt 359, Fairfax, VA 22031-4466 | 2017-08-01 |
| 1518396951 | Samantha Hancock | Physician Assistant | 10721 Main St Ste 200, Fairfax, VA 22030-6913 | 2013-11-06 |
| 1114263613 | Shoshana D Katz | Physician Assistant | 3031 Javier Rd Ste 210, Fairfax, VA 22031-4638 | 2013-01-02 |
| 1770610289 | Sonia J Mabout | Physician Assistant | 2812 Old Lee Hwy # 100b-d, Fairfax, VA 22031-4315 | 2007-02-28 |
| 1396705174 | Stephanie Anne Shepard | Physician Assistant | 2700 Prosperity Ave Ste 270, Fairfax, VA 22031-4321 | 2006-03-24 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.