Active NPI
Nancy Jeanne Tolk, BOC CERTIFIED
- Orthotic Fitter
- Fortuna, CA
National Provider Identifier
1033284039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotic Fitter
- Practice address
- 1013 Valley View Road
Fortuna, CA 95540-2229 - Phone
- (707) 725-6116
- Fax
- (707) 725-6116
- NPI assigned
- Nov 22, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | Primary |
Addresses
Primary practice location
1013 Valley View Road
Fortuna, CA 95540-2229
Mailing address
PO Box 725
1013 Valley View Road
Fortuna, CA 95540-2229
Phone (707) 725-6116
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C17591 | Other | BOARD OF CERTIFICATION NU | |
| 2275 | Other | REGISTERED |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033284039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 725",
"address_2": "1013 VALLEY VIEW ROAD",
"city": "FORTUNA",
"state": "CA",
"postal_code": "955402229",
"telephone_number": "707-725-6116",
"fax_number": "707-725-6116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1013 VALLEY VIEW ROAD",
"city": "FORTUNA",
"state": "CA",
"postal_code": "955402229",
"telephone_number": "707-725-6116",
"fax_number": "707-725-6116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOLK",
"first_name": "NANCY",
"middle_name": "JEANNE",
"name_prefix": "Mrs.",
"credential": "BOC CERTIFIED",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225000000X",
"taxonomy_group": "",
"desc": "Orthotic Fitter",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF CERTIFICATION NU",
"identifier": "C17591",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED",
"identifier": "2275",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fortuna, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.