Individual provider Active NPI

Kevin J Folchert, MD

  • Family Medicine Physician
  • South Sioux City, NE
National Provider Identifier
1124093695
Registry record updated Mar 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20197 Issued in NE
Practice address
3250 Plaza Dr
South Sioux City, NE 68776-3144
Phone
(402) 412-4220
Fax
(402) 494-1365
NPI assigned
Feb 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20197 NE Primary

Addresses

Primary practice location

3250 Plaza Dr
South Sioux City, NE 68776-3144

Mailing address

814 Pierce St
Suite 102
Sioux City, IA 51101-1058
Phone (712) 226-2600

Other identifiers 2

IdentifierTypeStateIssuer
1928259MedicaidIA
10025302400MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051011000311 IA Practitioner - Emergency MedicinePractitioner - Family Practice 6709801566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Sanford School of Medicine of University of South Dakota, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Iowa Hospital CorporationGroup PAC ID 0749198026, 139 clinicians

Practice addresses (Care Compare)

2720 Stone Park Blvd
Sioux City, IA 51104-3734
Phone (712) 279-3500

Hospital & facility affiliations

  • St Lukes Regional Medical Center Hospital, Sioux City, IA, CCN 160146

Merit-based Incentive Payment System (MIPS)

Final score
78.74 of 100Reported as group
Quality
76.47
Promoting interoperability
77
Improvement activities
40
Cost
71.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20197NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
Northwest Iowa Hospital Corporation CurrentSince Mar 1, 2017 Accepting new patients
St Lukes Health Resources Family Medicine Past Accepting new patients
Family Health Care of Siouxland LLC Family Medicine Past Accepting new patients

Locations

2730 Pierce St
Ste 205
Sioux City, IA 51104
Phone (712) 279-3383

2720 Stone Park Blvd
Sioux City, IA 51104
Phone (712) 259-3000

Interoperability endpoints

  • Direct secure messaging: kfolchert128204@direct.unitypoint.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299542400000",
    "number": "1124093695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 PIERCE ST",
            "address_2": "SUITE 102",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511011058",
            "telephone_number": "712-226-2600",
            "fax_number": "712-226-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 PLAZA DR",
            "city": "SOUTH SIOUX CITY",
            "state": "NE",
            "postal_code": "687763144",
            "telephone_number": "402-412-4220",
            "fax_number": "402-494-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLCHERT",
        "first_name": "KEVIN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2011-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "20197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1928259",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025302400",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Sioux City, NE

Sources for this page

Verify at the official NPI Registry.