David Werner Koelsch, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

47206 Issued in TN

Practice address

120 Administration Rd
Oak Ridge, TN 37830-8822

Phone

(865) 483-7030

Fax

(865) 483-3954

NPI assigned

Aug 15, 2005

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 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

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 1

Specialty

General Surgery

Education

University of Tennessee, HSC, College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Covenant Medical Group Inc 363 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Medical Center of Oak Ridge Hospital, Oak Ridge, TN, CCN 440034

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles (3 of 6)

Locations

Networks

• MS PPO D-SNP
• MS PPO
• MS PPO C-SNP

Interoperability endpoints

• Direct secure messaging: koelsch.david.werner@covenanthealth.cernerdirect.com
• FHIR API: https://fhir4.healow.com/fhir/r4/BBJECA/Endpoint/BBJECA

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.

• Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1457302010

  Surgery, TN

  Medicare reassignment Care Compare group NPD
• Covenant Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1871269415
  Care Compare group NPD
• Covenant Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Alcoa, TN
  • NPI 1093312415
  Care Compare group
• Covenant Medical Group, Inc

  • Urology Physician
  • Knoxville, TN
  • NPI 1386241859
  Care Compare group
• Covenant Medical Group, Inc

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1881636488
  Care Compare group
• Methodist Medical Center

  • General Acute Care Hospital
  • Oak Ridge, TN
  • NPI 1700870672
  NPD (past)

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

• Methodist Medical Center

  • General Acute Care Hospital
  • Oak Ridge, TN
  • NPI 1700870672

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1013919489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 ADMINISTRATION RD",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378308822",
            "telephone_number": "865-483-7030",
            "fax_number": "865-483-3954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 ADMINISTRATION RD",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378308822",
            "telephone_number": "865-483-7030",
            "fax_number": "865-483-3954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOELSCH",
        "first_name": "DAVID",
        "middle_name": "WERNER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "47206",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "36460",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PIN #",
            "identifier": "000000191916",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q073499",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "koelsch.david.werner@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "120 Administration Rd",
            "city": "Oak Ridge",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378308822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lacey King, CRNA
• Meridith Elise Hawkins King, DO
• Amy Elizabeth Knapp, PT, DPT
• Adrian Weldon Knauss, PHD, LMFT
• Knoxville Center for Oral & Maxillofacial Surgery, PC
• Christopher N Koontz, LCSW
• Bernadette Kos, MA
• Lalita Krishnan, M.D.
• Kroger Limited Partnership I
• Janet Rae Kropp, MA CCC-SLP

• All providers in Oak Ridge, TN
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.