Individual provider Active NPI

Katherine Henderson Harold, DO

  • Anesthesiology Physician
  • Dayton, OH
National Provider Identifier
1184039158
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
79921 Issued in GA
Practice address
405 W Grand Ave
Dayton, OH 45405-4720
Phone
(937) 723-3248
NPI assigned
Jun 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 79921 GA Primary

Addresses

Primary practice location

405 W Grand Ave
Dayton, OH 45405-4720

Mailing address

4440 Ackerman Blvd
Kettering, OH 45429-5502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20181005000569 GA Practitioner - Anesthesiology 5193077998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
West Virginia School of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Anesthesiology Associates of Georgia LLCGroup PAC ID 7618934779, 230 clinicians

Practice addresses (Care Compare)

11705 Mercy Blvd
Savannah, GA 31419-1711
Phone (912) 819-4100

215 Mims Rd
Sylvania, GA 30467-1994
Phone (912) 827-6536

247 S Main St
Reidsville, GA 30453-4605
Phone (912) 557-1207

2701 N Decatur Rd
Decatur, GA 30033-5918
Phone (678) 514-1991

5353 Reynolds St
Savannah, GA 31405-6015
Phone (912) 819-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79921GAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology Associates of Georgia, LLC Anesthesiology CurrentSince Jul 9, 2018 Accepting new patients

Locations

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

247 S Main St
Reidsville, GA 30453
Phone (478) 787-6255

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

210 E Derenne Ave
Savannah, GA 31405
Phone (912) 355-0140

5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172

215 Mims Rd
Sylvania, GA 30467
Phone (912) 557-1207

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.

Hospital & facility affiliations 5

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": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1184039158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 ACKERMAN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W GRAND AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454054720",
            "telephone_number": "937-723-3248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAROLD",
        "first_name": "KATHERINE",
        "middle_name": "HENDERSON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-27",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "79921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.