Individual provider Active NPI

Katalin Wolford, MD

  • Internal Medicine Physician
  • Vancouver, WA
National Provider Identifier
1306862834
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00036919 Issued in WA
Practice address
222 NE Park Plaza Dr
Siute 100
Vancouver, WA 98684-5895
Phone
(360) 254-8025
Fax
(360) 254-8618
NPI assigned
Jul 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00036919 WA Primary

Addresses

Primary practice location

222 NE Park Plaza Dr
Siute 100
Vancouver, WA 98684-5895

Mailing address

PO Box 1517
Pendleton, OR 97801-0410
Phone (877) 708-1119

Other identifiers 1

IdentifierTypeStateIssuer
8238214MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20051012001124 WA Practitioner - Internal Medicine 2860417466 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00036919WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Praxis Health, PC Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Praxis Health, PC CurrentSince Jan 1, 2022 Accepting new patients

Locations

222 NE Park Plaza Dr
Ste 100
Vancouver, WA 98684
Phone (360) 254-8025

Organizations & group practices 2

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": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1306862834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1517",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010410",
            "telephone_number": "877-708-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 NE PARK PLAZA DR",
            "address_2": "SIUTE 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845895",
            "telephone_number": "360-254-8025",
            "fax_number": "360-254-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFORD",
        "first_name": "KATALIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00036919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8238214",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.