Active NPI
Kenneth H Koster, MD
- Emergency Medicine Physician
- Fairfield, OH
National Provider Identifier
1386696326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 35051968K
- Practice address
- 3000 Mack Rd
Fairfield, OH 45014-5335 - Phone
- (513) 870-7001
- Fax
- (513) 603-8174
- NPI assigned
- May 17, 2006
- Last updated
- Oct 18, 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 35051968K | OH | Primary |
Addresses
Primary practice location
3000 Mack Rd
Fairfield, OH 45014-5335
Mailing address
4750 Hempstead Station Dr
Kettering, OH 45429-5164
Phone (800) 875-0136
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000316070 | Other | OH | BCBS FAIRFIELD |
| P00089914 | Other | RR MEDICARE FAIRFIELD | |
| 0867941 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35051968K | OH | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192665600000",
"number": "1386696326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4750 HEMPSTEAD STATION DR",
"city": "KETTERING",
"state": "OH",
"postal_code": "454295164",
"telephone_number": "800-875-0136",
"fax_number": "937-619-4231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 MACK RD",
"city": "FAIRFIELD",
"state": "OH",
"postal_code": "450145335",
"telephone_number": "513-870-7001",
"fax_number": "513-603-8174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOSTER",
"first_name": "KENNETH",
"middle_name": "H",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2007-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OH",
"license": "35051968K",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS FAIRFIELD",
"identifier": "000000316070",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE FAIRFIELD",
"identifier": "P00089914",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0867941",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.