Individual provider Active NPI

Tony James Koehler, DC

  • Chiropractor
  • Scottsdale, AZ
National Provider Identifier
1376017202
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8732 Issued in AZ
Practice address
14891 N Northsight Blvd Ste 117
Scottsdale, AZ 85260-2635
Phone
(480) 408-8684
Fax
(480) 999-5561
NPI assigned
Jan 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 8732 AZ Primary

Addresses

Primary practice location

14891 N Northsight Blvd Ste 117
Scottsdale, AZ 85260-2635

Mailing address

14891 N Northsight Blvd Ste 117
Scottsdale, AZ 85260-2635
Phone (480) 408-8684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220603001380 AZ Practitioner - Chiropractic 7416335443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14891 N Northsight Blvd
Suite 117
Scottsdale, AZ 85260-2635
Phone (480) 408-8684

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8732AZMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1376017202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14891 N NORTHSIGHT BLVD STE 117",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602635",
            "telephone_number": "480-408-8684",
            "fax_number": "480-999-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14891 N NORTHSIGHT BLVD STE 117",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602635",
            "telephone_number": "480-408-8684",
            "fax_number": "480-999-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHLER",
        "first_name": "TONY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-14",
        "last_updated": "2022-04-26",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.