Active NPI
Kristy M Wolff, M.D.
- Obstetrics & Gynecology Physician
- Fortuna, CA
National Provider Identifier
1972548436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- A77441
- Practice address
- 3307 Renner Dr
Fortuna, CA 95540-3119 - Phone
- (707) 725-6108
- Fax
- (707) 725-2651
- NPI assigned
- Jun 18, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | A77441 | CA | Primary |
Addresses
Primary practice location
3307 Renner Dr
Fortuna, CA 95540-3119
Mailing address
3307 Renner Dr
Fortuna, CA 95540-3119
Phone (707) 725-6108
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0087580 | Medicaid | CA | |
| ZZZ00521Z | Other | CA | BLUE SHIELD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| A77441 | CA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Redwood Women'S Health Center | Obstetrics & Gynecology | 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": "1150588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972548436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3307 RENNER DR",
"city": "FORTUNA",
"state": "CA",
"postal_code": "955403119",
"telephone_number": "707-725-6108",
"fax_number": "707-725-2651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3307 RENNER DR",
"city": "FORTUNA",
"state": "CA",
"postal_code": "955403119",
"telephone_number": "707-725-6108",
"fax_number": "707-725-2651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLFF",
"first_name": "KRISTY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "CA",
"license": "A77441",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0087580",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "ZZZ00521Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fortuna, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.