Michael P Koelsch MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M3819 Issued in ID

Legal business name

MICHAEL P KOELSCH MD

Practice address

805 N 6TH E
Mountain Home, ID 83647-2207

Phone

(208) 587-5880

Fax

(208) 587-7905

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

Mary Lou Koelsch

Title

Office Manager

Phone

(208) 587-5880

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379635200000",
    "number": "1356475115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 940",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836470940",
            "telephone_number": "208-587-5880",
            "fax_number": "208-587-7905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N 6TH E",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836472207",
            "telephone_number": "208-587-5880",
            "fax_number": "208-587-7905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL P KOELSCH MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2013-09-20",
        "status": "A",
        "authorized_official_last_name": "KOELSCH",
        "authorized_official_first_name": "MARY LOU",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-587-5880"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M3819",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP382A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP",
            "identifier": "8H732",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805234300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonnie Jean Markham, LMSW
• Karen Beatrice Mashak, L.M.
• Christine May, CD(DONA)
• Shawna M McCaffrey, FNP-C
• Stacey McFarland-Smith, MS OTR/L
• Frank Monasterio, LPC
• Laura Jean Moulton, R.D.N.
• Mountain Gem Counseling, LLC
• Mountain Home Behavioral Health LLC
• Mountain Home Dental PC

• Internal Medicine Physician in Mountain Home, ID
• Providers in Mountain Home, ID by specialty
• Internal Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.