Active NPI
Kerry D Rold, M.D.
- Diagnostic Radiology Physician
- Redlands, CA
National Provider Identifier
1043267156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- G40694
- Practice address
- 2 West Fern Ave
Redlands, CA 92373-5916 - Phone
- (909) 793-3311
- Fax
- (909) 796-4158
- NPI assigned
- May 27, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | G40694 | CA | Primary |
Addresses
Primary practice location
2 West Fern Ave
Redlands, CA 92373-5916
Mailing address
PO Box 2200
Redlands, CA 92373-0722
Phone (909) 793-3311
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G40694 | CA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Citrus Valley Imaging, Inc | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Diagnostic Radiology Physician
- Redlands, CA
- NPI 1134167513
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197849600000",
"number": "1043267156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2200",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923730722",
"telephone_number": "909-793-3311",
"fax_number": "909-796-4158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 WEST FERN AVE",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923735916",
"telephone_number": "909-793-3311",
"fax_number": "909-796-4158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROLD",
"first_name": "KERRY",
"middle_name": "D",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-27",
"last_updated": "2007-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "G40694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.