Individual provider Active NPI

Kenneth Dale Krone, M.D.

  • Diagnostic Radiology Physician
  • Avila Beach, CA
National Provider Identifier
1639175672
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G23988 Issued in CA
Practice address
2845 Rock Wren LN
Avila Beach, CA 93424-3536
Phone
(805) 627-1713
Fax
(888) 691-8259
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G23988 CA Primary

Addresses

Primary practice location

2845 Rock Wren LN
Avila Beach, CA 93424-3536

Mailing address

PO Box 2605
Avila Beach, CA 93424-2605
Phone (805) 627-1713

Other identifiers 1

IdentifierTypeStateIssuer
00G239880MedicaidCA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G23988CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra Imaging Associates Medical Group Professional Corporation Diagnostic Radiology 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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1639175672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2605",
            "city": "AVILA BEACH",
            "state": "CA",
            "postal_code": "934242605",
            "telephone_number": "805-627-1713",
            "fax_number": "888-691-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 ROCK WREN LN",
            "city": "AVILA BEACH",
            "state": "CA",
            "postal_code": "934243536",
            "telephone_number": "805-627-1713",
            "fax_number": "888-691-8259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRONE",
        "first_name": "KENNETH",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G23988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G239880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avila Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.