John Koehler, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

ME133563 Issued in FL

Practice address

1840 Eldron Blvd SE Ste 1
Palm Bay, FL 32909-6871

Phone

(321) 312-4580

Fax

(321) 914-4053

NPI assigned

Dec 29, 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

Medicare fee-for-service enrollment

Enrolled in IL, IN, WI3 enrollments

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 3

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.koehler.1@17569.direct.athenahealth.com

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.

• Physicians Immediate Care North Chicago LLC

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1205814118
  Medicare reassignment NPD
• Pic Indiana PC

  • Urgent Care Clinic/Center
  • Mishawaka, IN
  • NPI 1942546890
  Medicare reassignment NPD
• Fastrac Medical, P.C.

  • Emergency Medicine Physician
  • Joliet, IL
  • NPI 1659517597
  NPD (past)

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1144207366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 ELDRON BLVD SE STE 1",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329096871",
            "telephone_number": "321-312-4580",
            "fax_number": "321-914-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 ELDRON BLVD SE STE 1",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329096871",
            "telephone_number": "321-312-4580",
            "fax_number": "321-914-4053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3475 S Alpine Rd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611092604",
            "country_code": "US",
            "telephone_number": "815-874-8000",
            "fax_number": "815-874-7525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3475 S Alpine Rd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611092604",
            "country_code": "US",
            "telephone_number": "815-874-8000",
            "fax_number": "815-874-7525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOEHLER",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PT0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Medical Toxicology",
            "state": "IL",
            "license": "36072658",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME133563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terence Allen Kitchens
• Nancy Shaffer Klein
• Kaylie Knapp
• Dave Kneessy, MS, MAC, MCAP, LMHC
• De'Edra L. Knight
• Reegan Koppelman
• Cynthia Ann Koppler, LCSW
• Katlin Krakowiak, PHARMD
• Robert Krenzer, MD
• Kristen Dempsey LLC

• Emergency Medicine Physician in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.