Active NPI
Melinda Koehne
- Blind Rehabilitation Specialist/Technologist
- Indianapolis, IN
National Provider Identifier
1164076501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Blind Rehabilitation Specialist/Technologist
- License
- 1425191
- Practice address
- 1212 Southeastern Ave
Indianapolis, IN 46202-3948 - Phone
- (888) 824-2197
- NPI assigned
- Jul 24, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Blind Rehabilitation Specialist/Technologist | 2255R0406X | 1425191 | IN | Primary |
Addresses
Primary practice location
1212 Southeastern Ave
Indianapolis, IN 46202-3948
Mailing address
1212 Southeastern Ave
Indianapolis, IN 46202-3948
Phone (888) 824-2197
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1425191 | IN | MD | Blind Rehabilitation Specialist/Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649721600000",
"number": "1164076501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1212 SOUTHEASTERN AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462023948",
"telephone_number": "888-824-2197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 SOUTHEASTERN AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462023948",
"telephone_number": "888-824-2197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOEHNE",
"first_name": "MELINDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-24",
"last_updated": "2022-04-12",
"certification_date": "2022-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "2255R0406X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Rehabilitation, Blind",
"state": "IN",
"license": "1425191",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.