Active NPI
Kenneth Jon Folsom, M.D.
- Dermatology Physician
- Boca Raton, FL
National Provider Identifier
1831410315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- ME0041227
- Practice address
- 3902 NW 23Rd CT
Boca Raton, FL 33431-5446 - Phone
- (561) 706-7550
- NPI assigned
- Jun 18, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | ME0041227 | FL | Primary |
Addresses
Primary practice location
3902 NW 23Rd CT
Boca Raton, FL 33431-5446
Mailing address
3902 NW 23Rd CT
Boca Raton, FL 33431-5446
Phone (561) 706-7550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0041227 | FL | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276819200000",
"number": "1831410315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3902 NW 23RD CT",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334315446",
"telephone_number": "561-706-7550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3902 NW 23RD CT",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334315446",
"telephone_number": "561-706-7550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOLSOM",
"first_name": "KENNETH",
"middle_name": "JON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-18",
"last_updated": "2010-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "FL",
"license": "ME0041227",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; 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.