Active NPI
Katie Radkowski
- Physician Assistant
- Bakersfield, CA
National Provider Identifier
1275886772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 9802 Stockdale Hwy
102
Bakersfield, CA 93311-3652 - Phone
- (661) 323-1200
- Fax
- (661) 323-1204
- NPI assigned
- Oct 22, 2012
- Last updated
- Dec 8, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
9802 Stockdale Hwy
102
Bakersfield, CA 93311-3652
Mailing address
PO Box 21873
Bakersfield, CA 93390-1873
Phone (661) 323-1200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22723 | CA | MD | Professional Counselor |
Interoperability endpoints
- klr110pcs@m1133.primeclinicalsystems.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354924800000",
"number": "1275886772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 21873",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933901873",
"telephone_number": "661-323-1200",
"fax_number": "661-323-1204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9802 STOCKDALE HWY",
"address_2": "102",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933113652",
"telephone_number": "661-323-1200",
"fax_number": "661-323-1204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADKOWSKI",
"first_name": "KATIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-22",
"last_updated": "2012-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.