Kraig Elmer Lorenzen, MD, PH.D

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

G89146 Issued in CA

Practice address

205 E Ray Fine Blvd Suite 5
Roland, OK 74954

Phone

(918) 503-6235

Fax

(918) 503-6239

NPI assigned

Nov 16, 2015

Last updated

Nov 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 18, 2017 through May 18, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1689048571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 961",
            "city": "ROLAND",
            "state": "OK",
            "postal_code": "74954",
            "telephone_number": "918-503-6235",
            "fax_number": "918-503-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E RAY FINE BLVD SUITE 5",
            "city": "ROLAND",
            "state": "OK",
            "postal_code": "74954",
            "telephone_number": "918-503-6235",
            "fax_number": "918-503-6239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORENZEN",
        "first_name": "KRAIG",
        "middle_name": "ELMER",
        "name_prefix": "Dr.",
        "credential": "MD, PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-16",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G89146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lequita Jo Joyce, M.A.,LPC,LMFT
• Bobbie Just
• Robert Kale, M.D.
• Lequita J. Joyce Inc (Roland Family Counseling Center)
• Liberty Public Sschool
• Darrell Madison Jr.
• Bobbie Jo Martin
• Bonnie McDonald
• Medstaffpc
• Tonya Mills, LPN

• Diagnostic Radiology Physician in Roland, OK
• Providers in Roland, OK by specialty
• Diagnostic Radiology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.