Individual provider Active NPI

Janine Kohler, D.O.

  • Family Medicine Physician
  • Traverse City, MI
National Provider Identifier
1194770347
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101013080 Issued in MI
Practice address
5015 N Royal Dr
Traverse City, MI 49684-9292
Phone
(231) 935-0850
Fax
(231) 935-0850
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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 5101013080 MI Primary

Addresses

Primary practice location

5015 N Royal Dr
Traverse City, MI 49684-9292

Mailing address

5015 N Royal Dr
Traverse City, MI 49684-9292
Phone (231) 935-0850

Other identifiers 1

IdentifierTypeStateIssuer
4188925MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20101112000271 MI Practitioner - Family Practice 2769677087 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Front Primary Care PLLCGroup PAC ID 4183514706, 20 clinicians
Grand Traverse Internists PCGroup PAC ID 0042374977, 8 clinicians

Practice addresses (Care Compare)

4290 Copper Ridge Dr
Suite 200
Traverse City, MI 49684-7205
Phone (231) 935-8930

5015 N Royal Dr
Traverse City, MI 49684-9292
Phone (231) 935-0850

Hospital & facility affiliations

  • Munson Home Care Home health agency, Traverse City, MI, CCN 237025
  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097
  • Paul Oliver Memorial Hospital Hospital, Frankfort, MI, CCN 231300

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Traverse Internists, PC CurrentSince May 15, 2024 Accepting new patients

Locations

5015 N Royal Dr
Traverse City, MI 49684
Phone (231) 935-0850

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FIAHAA/Endpoint/FIAHAA
  • Direct secure messaging: janine.kohler@gti.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/FIAHAA

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1194770347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849292",
            "telephone_number": "231-935-0850",
            "fax_number": "231-935-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849292",
            "telephone_number": "231-935-0850",
            "fax_number": "231-935-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLER",
        "first_name": "JANINE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4188925",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.