Kenneth Alan Wolkoff, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

174127-1205 Issued in UT

Practice address

3065 Fawn Dr
Park City, UT 84098-5368

Phone

(435) 655-8212

NPI assigned

May 19, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053529255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3065 FAWN DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 FAWN DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985368",
            "telephone_number": "435-655-8212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLKOFF",
        "first_name": "KENNETH",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "174127-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Wilson
• Michelle Hill Wilson, MD
• Patricia K Winkelman, D.C.
• Robert T Winn, M.D.
• Amanda Jane Wissler, LCSW
• Kary Ellen Woodruff, R.D., M.S., C.D.
• Kelly H Woodward I, D.O., M.P.H.
• Cade Benjamin Woolsey
• Courtney N. Woolsey, RD
• Shelley Worley

• Family Medicine Physician in Park City, UT
• Providers in Park City, UT by specialty
• Family Medicine Physician in Utah

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.