Individual provider Active NPI

Katherine Ann Thokey Klco, D.D.S.

  • General Practice Dentistry
  • Madison, OH
National Provider Identifier
1073779005
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20100 Issued in OH
Practice address
24 Lexington Blvd
Madison, OH 44057-3150
Phone
(440) 428-9568
Fax
(440) 428-5667
NPI assigned
Jul 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20100 OH Primary

Addresses

Primary practice location

24 Lexington Blvd
Madison, OH 44057-3150

Mailing address

24 Lexington Blvd
Madison, OH 44057-3150
Phone (440) 428-9568

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160804002775 OH Order and Referring Only - DentistPractitioner - Dentist 5597059154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20100OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1073779005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 LEXINGTON BLVD",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440573150",
            "telephone_number": "440-428-9568",
            "fax_number": "440-428-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 LEXINGTON BLVD",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440573150",
            "telephone_number": "440-428-9568",
            "fax_number": "440-428-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOKEY KLCO",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "20100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, OH

Sources for this page

Verify at the official NPI Registry.