Active NPI
James T Wolfe, DDS
- Periodontics
- Kokomo, IN
National Provider Identifier
1972654622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 12009605A
- Practice address
- 2705 S Berkley Rd
Ste 4a
Kokomo, IN 46902-8025 - Phone
- (765) 453-2619
- Fax
- (765) 453-5076
- NPI assigned
- Jan 16, 2007
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 12009605A | IN | Primary |
Addresses
Primary practice location
2705 S Berkley Rd
Ste 4a
Kokomo, IN 46902-8025
Mailing address
16439 Stony Ridge Dr
Noblesville, IN 46060-8071
Phone (317) 773-7944
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140424001403 | IN | Order and Referring Only - Oral Surgery | 5294968475 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| James T Wolfe, DDS, MSD, PC | Periodontics | 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.
-
- Periodontics
- Kokomo, IN
- NPI 1316064793
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396828800000",
"number": "1972654622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16439 STONY RIDGE DR",
"city": "NOBLESVILLE",
"state": "IN",
"postal_code": "460608071",
"telephone_number": "317-773-7944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2705 S BERKLEY RD",
"address_2": "STE 4A",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469028025",
"telephone_number": "765-453-2619",
"fax_number": "765-453-5076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLFE",
"first_name": "JAMES",
"middle_name": "T",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-16",
"last_updated": "2014-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "IN",
"license": "12009605A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; 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.