Koke Mill Medical Associates, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

KOKE MILL MEDICAL ASSOCIATES, LLC

Practice address

3132 Old Jacksonville Rd
Springfield, IL 62704-7400

Phone

(217) 862-0800

Fax

(217) 862-0871

NPI assigned

Oct 1, 2008

Organization subpart

No

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

Authorized official

Name

J. Travis Dowell

Title

Vice President Hcna and Operations

Phone

(217) 788-3342

Specialties & licenses 3

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Memorial Physician Services

  • Rural Health Clinic/Center
  • Jacksonville, IL
  • NPI 1558614867

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222819200000",
    "number": "1225289861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3428",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627083428",
            "telephone_number": "800-577-5368",
            "fax_number": "217-757-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3132 OLD JACKSONVILLE RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047400",
            "telephone_number": "217-862-0800",
            "fax_number": "217-862-0871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOKE MILL MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-01",
        "last_updated": "2008-10-01",
        "status": "A",
        "authorized_official_last_name": "DOWELL",
        "authorized_official_first_name": "J. TRAVIS",
        "authorized_official_title_or_position": "VICE PRESIDENT HCNA AND OPERATIONS",
        "authorized_official_telephone_number": "217-788-3342"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geza F Kogler, PHD
• Omid Kohannim, MD
• Kevin Thomas Kohut, MD
• Janak Koirala, M.D.
• Robert Kojima, M.D.
• Koke Mill Optical
• Michal Kolda, M.D.
• Vijay Sai Kollipara
• Amanda Lynne Kollmann, DPT
• Lavanya Kolluri, M.D.

• Internal Medicine Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; 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.