Shane K. Kohl, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

24106 Issued in NE

Practice address

8303 Dodge St
Omaha, NE 68114-4108

Phone

(402) 354-4540

Fax

(402) 354-4535

NPI assigned

Oct 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NE, IA2 enrollments

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.

Enrollment records 2

Specialty

Pathology

Education

University of Nebraska College of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Methodist Fremont HealthGroup PAC ID 7911258520, 89 clinicians

Nebraska Methodist HospitalGroup PAC ID 6901707447, 132 clinicians

Jennie Edmundson Memorial HospitalGroup PAC ID 9537064837, 59 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040
• Methodist Fremont Health Hospital, Fremont, NE, CCN 280077
• Montgomery County Memorial Hospital Hospital, Red Oak, IA, CCN 161363
• Methodist Jennie Edmundson Hospital, Council Bluffs, IA, CCN 160047
• Community Hospital Association Hospital, Fairfax, MO, CCN 261303

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Methodist Fremont Health

  • Internal Medicine Physician
  • Fremont, NE
  • NPI 1235618216
  Medicare reassignment Care Compare group NPD
• Nebraska Methodist Hospital

  • Emergency Medicine Physician
  • Omaha, NE
  • NPI 1689628372

  Anatomic Pathology & Clinical Pathology

  Medicare reassignment Care Compare group NPD
• Jennie Edmundson Memorial Hospital

  • Emergency Medicine Physician
  • Council Bluffs, IA
  • NPI 1942251269
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Methodist Fremont Health

  • Rural Acute Care Hospital
  • Fremont, NE
  • NPI 1033698543
  Care Compare affiliation
• Methodist Fremont Health

  • Rural Acute Care Hospital
  • Fremont, NE
  • NPI 1376498543
  Care Compare affiliation
• Nebraska Methodist Hospital

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1427147883
  Care Compare affiliation
• Community Hospital Association

  • Critical Access Hospital
  • Fairfax, MO
  • NPI 1942279500
  Care Compare affiliation
• Jennie Edmundson Memorial Hospital

  • General Acute Care Hospital
  • Council Bluffs, IA
  • NPI 1457448755
  Care Compare affiliation
• Montgomery County Memorial Hospital

  • Critical Access Hospital
  • Red Oak, IA
  • NPI 1376539338
  Care Compare affiliation

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1013105899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2797",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681032797",
            "telephone_number": "402-354-4230",
            "fax_number": "402-354-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8303 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144108",
            "telephone_number": "402-354-4540",
            "fax_number": "402-354-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHL",
        "first_name": "SHANE",
        "middle_name": "K.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-05",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WA",
            "license": "MD00048195",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NE",
            "license": "24106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD00048195",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013105899",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "24106",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47037660422",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Kay Koglin
• Zobida Kohistani
• Allison J Kohl
• Jami Kohl
• Mitchell Kohl, MD
• Jenna Lee Kohler, APRN
• Michaela L Kohler, PA-C
• Georgia Rae Kohlhorst
• Anisha Kohli
• Anna Kohll

• Anatomic Pathology & Clinical Pathology Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Anatomic Pathology & Clinical Pathology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.