Individual provider Active NPI

Joanna Koehler, RDN

  • Registered Dietitian
  • Tullahoma, TN
National Provider Identifier
1194428235
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LDN0000003845 Issued in TN
Practice address
810 W Hickory St
Tullahoma, TN 37388-3100
Phone
(573) 837-8763
NPI assigned
Mar 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LDN0000003845 TN Primary

Addresses

Primary practice location

810 W Hickory St
Tullahoma, TN 37388-3100

Mailing address

810 W Hickory St
Tullahoma, TN 37388-3100
Phone (573) 837-8763

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LDN0000003845TNMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1194428235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 W HICKORY ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373883100",
            "telephone_number": "573-837-8763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W HICKORY ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373883100",
            "telephone_number": "573-837-8763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHLER",
        "first_name": "JOANNA",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TN",
            "license": "LDN0000003845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tullahoma, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.