Theodore G Koerner, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MB031874 Issued in NJ

Practice address

4911 Black Horse Pike (RT 42)
Turnersville, NJ 08012-1730

Phone

(856) 227-7048

NPI assigned

Sep 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1245225366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1107",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080120877",
            "telephone_number": "856-227-7048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4911 BLACK HORSE PIKE (RT 42)",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080121730",
            "telephone_number": "856-227-7048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOERNER",
        "first_name": "THEODORE",
        "middle_name": "G",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB031874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH NJ",
            "identifier": "0073996001",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5433019",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2191105",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Susan Kerr, BA, NCPRSS
• Kic Behavioral & Counseling Services LLC
• Brooke Kieserman
• Alexis Kilduff, LPC
• Krista H King, M.D.
• Jeffrey Konzelman, PA-S
• Phillip Alexander Korth, MD
• Dana Marie Kostas, M.A., LAC
• Ronald Scott Kovac, DDS
• Michele Kovach, LMT

• Family Medicine Physician in Turnersville, NJ
• Providers in Turnersville, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.