Individual provider Active NPI

Rodney Alan Koehler, ATC

  • Athletic Trainer
  • Dodge City, KS
National Provider Identifier
1417043274
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
24-00099 Issued in KS
Practice address
1909 N. 14TH St.
Ste C
Dodge City, KS 67801
Phone
(620) 338-8633
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 24-00099 KS Primary

Addresses

Primary practice location

1909 N. 14TH St.
Ste C
Dodge City, KS 67801

Mailing address

1909 N. 14TH St.
Ste C
Dodge City, KS 67801
Phone (620) 338-8633

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
24-00099KSMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417043274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 N. 14TH ST.",
            "address_2": "STE C",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "67801",
            "telephone_number": "620-338-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 N. 14TH ST.",
            "address_2": "STE C",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "67801",
            "telephone_number": "620-338-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHLER",
        "first_name": "RODNEY",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KS",
            "license": "24-00099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dodge City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.