Individual provider Active NPI

Corinne E Kohler, MD

  • Family Medicine Physician
  • Champaign, IL
National Provider Identifier
1053386250
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036093780 Issued in IL
Practice address
819 Bloomington Rd
Champaign, IL 61820-2101
Phone
(217) 356-1558
NPI assigned
Feb 21, 2006
Last updated
Oct 25, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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 036093780 IL Primary

Addresses

Primary practice location

819 Bloomington Rd
Champaign, IL 61820-2101

Mailing address

819 Bloomington Rd
Champaign, IL 61820-2101
Phone (217) 356-1558

Other identifiers 1

IdentifierTypeStateIssuer
036093780MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20040721000302 IL Practitioner - Family Practice 8022098169 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036093780ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Improvement Center CurrentSince Feb 20, 2016 Accepting new patients
Community Health Improvement Center Current Accepting new patients
Promise Healthcare NFP CurrentSince Jan 1, 2013 Accepting new patients
Promise Healthcare NFP CurrentSince Jan 1, 2013 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

819 Bloomington Rd
Champaign, IL 61820
Phone (217) 356-1558

2905 N Main St
Decatur, IL 62526
Phone (217) 877-9117

320 E Central Ave
Decatur, IL 62521
Phone (217) 877-4694

1002 S Race St
Urbana, IL 61801
Phone (217) 239-4220

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1053386250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 BLOOMINGTON RD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618202101",
            "telephone_number": "217-356-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 BLOOMINGTON RD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618202101",
            "telephone_number": "217-356-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLER",
        "first_name": "CORINNE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036093780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093780",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.