Active NPI
Johan Kohler, D.O.
- Family Medicine Physician
- Keizer, OR
National Provider Identifier
1245355643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- DO151219
- Practice address
- 5900 Inland Shores Way N
Keizer, OR 97303-3795 - Phone
- (503) 399-2470
- Fax
- (503) 375-7429
- NPI assigned
- Mar 21, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DO151219 | OR | Primary |
Addresses
Primary practice location
5900 Inland Shores Way N
Keizer, OR 97303-3795
Mailing address
PO Box 8100
Salem, OR 97303-0900
Phone (503) 399-2470
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500622682 | Medicaid | OR | |
| CS4159 | Other | OR | RAILROAD MEDICARE GROUP PTAN |
| P00899090 | Other | OR | RAILROAD MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5900 Inland Shores Way N
Suite 100
Keizer, OR 97303-3883
Phone (503) 399-2424
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3921 | AZ | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| DO151219 | OR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Salem Clinic, PC | Current | Accepting new patients | |
| Dana Landing Urgent Care LLC | Past | Accepting new patients | |
| Desert Ridge Urgent Care LLC | Past | Accepting new patients | |
| Chandler Urgent Care LLC | Past | Accepting new patients | |
| Salem Clinic, PC | Past | Accepting new patients | |
| Shea Urgent Care LLC | Past | Accepting new patients | |
| Pinnacle Medicine Inc. | Past | Accepting new patients | |
| Sun Valley Urgent Care | Family Medicine | Past | Accepting new patients |
| Glendale Urgent Care LLC | Past | Accepting new patients | |
| Greenway Urgent Care LLC | Past | Accepting new patients | |
| Avondale Urgent Care LLC | Past | Accepting new patients | |
| Sun City Urgent Care LLC | Past | Accepting new patients |
Locations
5900 Inland Shores Way N
Keizer, OR 97303
Phone (503) 485-4787
5900 Inland Shores Way N
Ste 100
Keizer, OR 97303
2531 Boone Rd SE
Salem, OR 97306
Phone (503) 399-2470
2020 Capitol St NE
Salem, OR 97301
Phone (503) 399-2470
Interoperability endpoints
- jkohler39003@salemclinic.gardenplot.direct-ci.com
Organizations & group practices 12
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.
-
- General Practice Physician
- Salem, OR
- NPI 1912935594
-
- General Practice Physician
- Keizer, OR
- NPI 1992973622
-
- Family Medicine Physician
- Goodyear, AZ
- NPI 1093858003
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311292800000",
"number": "1245355643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8100",
"city": "SALEM",
"state": "OR",
"postal_code": "973030900",
"telephone_number": "503-399-2470",
"fax_number": "503-375-7429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 INLAND SHORES WAY N",
"city": "KEIZER",
"state": "OR",
"postal_code": "973033795",
"telephone_number": "503-399-2470",
"fax_number": "503-375-7429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHLER",
"first_name": "JOHAN",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-21",
"last_updated": "2011-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "DO151219",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500622682",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE GROUP PTAN",
"identifier": "CS4159",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PTAN",
"identifier": "P00899090",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Keizer, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.