Individual provider Active NPI

Susan Koehler, MD

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1023078136
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0068255 Issued in FL
Practice address
2080 Child St
Jacksonville, FL 32214-5005
Phone
(904) 542-7800
NPI assigned
Mar 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME0068255 FL Primary

Addresses

Primary practice location

2080 Child St
Jacksonville, FL 32214-5005

Mailing address

1570 Ibis Dr
Orange Park, FL 32065-7398

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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

Enrollment IDStateProvider typePAC IDDetails
I20251230001694 KS Practitioner - Family Practice 5294775334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Creighton University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawrence Physicians LLCGroup PAC ID 1951623834, 223 clinicians

Practice addresses (Care Compare)

2001 Haskell Ave
Suite a
Lawrence, KS 66046-3249
Phone (785) 505-5420

Hospital & facility affiliations

  • LMH Hospital, Lawrence, KS, CCN 170137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0068255FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence Physicians LLC Family Medicine CurrentSince Jan 5, 2026 Accepting new patients
Lawrence Physicians LLC CurrentSince Jan 5, 2026 Accepting new patients
St Vincents Medical Center Inc Past Accepting new patients
The Internal Medicine Group PA Past Accepting new patients
St Vincents Medical Center Inc Past Accepting new patients

Locations

2001 Haskell Ave
Ste A
Lawrence, KS 66046
Phone (785) 505-5420

1130 W 4th St
Ste 2050
Lawrence, KS 66044
Phone (785) 505-3636

325 Maine St
Lawrence, KS 66044
Phone (785) 505-2988

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1023078136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 IBIS DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320657398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CHILD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322145005",
            "telephone_number": "904-542-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHLER",
        "first_name": "SUSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0068255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.