Cassidy Lynn Koehler

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

BACB478510 Issued in FL

Practice address

8001 Beaty Grove Dr
Tampa, FL 33626-1602

Phone

(813) 926-5454

Fax

(813) 920-9252

NPI assigned

Feb 1, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1043775299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12030 HOLBROOK DR APT 8",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346672949",
            "telephone_number": "407-738-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 BEATY GROVE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261602",
            "telephone_number": "813-926-5454",
            "fax_number": "813-920-9252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHLER",
        "first_name": "CASSIDY",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-01",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "BACB478510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BACB478510",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Poornma Kodwani
• Ivana Karaban Koebel
• Julia Lynn Koebel
• Jennifer Rose Baker Koebert, PA-C
• Amy Koehler
• Jessica D Koehler, APRN
• Nicholas E Koehler, MD
• Thomas Jared Koehler
• Patricia Koelig
• Himara Koelmeyer, MD

• Behavior Technician in Tampa, FL
• Providers in Tampa, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; 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.