Individual provider Active NPI

Kenneth Ronald Golda, DPM

  • Podiatrist
  • Oklahoma City, OK
National Provider Identifier
1649368721
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
145 Issued in OK
Practice address
1522 SW 89TH Street
Oklahoma City, OK 73159
Phone
(405) 691-6694
Fax
(405) 691-6404
NPI assigned
Oct 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 145 OK Primary

Addresses

Primary practice location

1522 SW 89TH Street
Oklahoma City, OK 73159

Mailing address

1522 SW 89TH Street
Oklahoma City, OK 73159
Phone (405) 691-6694

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031217000356 OK Practitioner - Podiatry 1052218179 Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
145OKMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jayson G Cortez LLC PastSince Jul 1, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649368721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1522 SW 89TH STREET",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73159",
            "telephone_number": "405-691-6694",
            "fax_number": "405-691-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1522 SW 89TH STREET",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73159",
            "telephone_number": "405-691-6694",
            "fax_number": "405-691-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDA",
        "first_name": "KENNETH",
        "middle_name": "RONALD",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OK",
            "license": "145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.