Organization Active NPI

Kathrin a Koehler

  • Clinical Psychologist
  • Springfield, OH
National Provider Identifier
1194359216
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
KATHRIN A KOEHLER
Practice address
4674 Hominy Ridge Rd
Springfield, OH 45502-8031
Phone
(937) 206-3458
NPI assigned
Feb 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Authorized official

Name
Kathrin A KoehlerNPI 1770114647
Title
Owner
Phone
(937) 206-3458

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

4674 Hominy Ridge Rd
Springfield, OH 45502-8031

Mailing address

4674 Hominy Ridge Rd
Springfield, OH 45502-8031
Phone (937) 206-3458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200505002926 OH Part B Supplier - Clinic/Group Practice 6608207733 Receives reassigned benefits from 1 practitioner
Practice locations: Springfield, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582761600000",
    "number": "1194359216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4674 HOMINY RIDGE RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455028031",
            "telephone_number": "937-206-3458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4674 HOMINY RIDGE RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455028031",
            "telephone_number": "937-206-3458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHRIN A KOEHLER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-27",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A",
        "authorized_official_last_name": "KOEHLER",
        "authorized_official_first_name": "KATHRIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-206-3458"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.