Individual provider Active NPI

Katherine E Black-Lee, DPM

  • Podiatrist
  • Madison, CT
National Provider Identifier
1154415438
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
P000360 Issued in CT
Practice address
145 Durham Rd
Madison, CT 06443-2674
Phone
(203) 245-4216
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X P000360 CT Primary

Addresses

Primary practice location

145 Durham Rd
Madison, CT 06443-2674

Mailing address

145 Durham Rd
Madison, CT 06443-2674
Phone (203) 245-4216

Other identifiers 1

IdentifierTypeStateIssuer
P000360OtherCTLICENSE (DPM)

Medicare participation

Medicare enrollment files
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: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P000360CTMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
David J. Golden, DPM, LLC Podiatrist 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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154415438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 DURHAM RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432674",
            "telephone_number": "203-245-4216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 DURHAM RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432674",
            "telephone_number": "203-245-4216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK-LEE",
        "first_name": "KATHERINE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CT",
            "license": "P000360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE (DPM)",
            "identifier": "P000360",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, CT

Sources for this page

Verify at the official NPI Registry.