Individual provider Active NPI

Warren E. Koffler, M.D.

  • Internal Medicine Physician
  • Mobile, AL
National Provider Identifier
1043225832
Registry record updated Jan 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
00007398 Issued in AL
Practice address
6701 Airport Blvd
Suite a-101
Mobile, AL 36608-6705
Phone
(251) 633-8880
Fax
(251) 634-4503
NPI assigned
Jul 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 00007398 AL Primary

Addresses

Primary practice location

6701 Airport Blvd
Suite a-101
Mobile, AL 36608-6705

Mailing address

PO Box 850489
Mobile, AL 36685-0489
Phone (251) 342-3949

Other identifiers 1

IdentifierTypeStateIssuer
000093290MedicaidAL

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

LicenseStateTypeSpecialty
00007398ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Healthcare Services Internal Medicine Current Accepting new patients

Locations

610 Providence Park Dr E
Ste 102
Mobile, AL 36695
Phone (251) 378-3900

6701 Airport Blvd
Ste A101
Mobile, AL 36608
Phone (251) 633-8880

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": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296086400000",
    "number": "1043225832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850489",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366850489",
            "telephone_number": "251-342-3949",
            "fax_number": "251-631-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 AIRPORT BLVD",
            "address_2": "SUITE A-101",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366086705",
            "telephone_number": "251-633-8880",
            "fax_number": "251-634-4503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOFFLER",
        "first_name": "WARREN",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2011-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "00007398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000093290",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.