Michael A Kolda, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

R2P59 Issued in MO

Practice address

800 Ste Genevieve Dr
Ste Genevieve, MO 63670-1434

Phone

(573) 883-2751

NPI assigned

Feb 23, 2007

Last updated

Sep 5, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southeast Missouri Hospital Physicians, LLC

  dba Mercy Clinic Southeast

  • Family Medicine Physician
  • Cape Girardeau, MO
  • NPI 1558311522
  Medicare reassignment NPD

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1346375870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 STE GENEVIEVE DR",
            "city": "STE GENEVIEVE",
            "state": "MO",
            "postal_code": "636701434",
            "telephone_number": "573-883-2751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 STE GENEVIEVE DR",
            "city": "STE GENEVIEVE",
            "state": "MO",
            "postal_code": "636701434",
            "telephone_number": "573-883-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLDA",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "R2P59",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deniane John, MD
• Mary Beth Jokerst, PTA
• Kent J Sadler DDS PC
• Hannah Elizabeth Kertz, MD
• Klein Eye Care I, Inc
• Casey Koller
• Henry Joseph Konzelmann, M.D.
• Dale M Kraenzle, FNP
• Jenna Kuehn, PTA
• Roland B Kuenzel, DC

• Emergency Medicine Physician in Ste Genevieve, MO
• Providers in Ste Genevieve, MO by specialty
• Emergency Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.