Philip Lee Koehler, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

4112 Issued in WI

Practice address

562 Majeskie Dr
Pewaukee, WI 53072-6534

Phone

(262) 695-4019

NPI assigned

Oct 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477642965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "562 MAJESKIE DR",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "53072",
            "telephone_number": "262-695-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "562 MAJESKIE DR",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530726534",
            "telephone_number": "262-695-4019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHLER",
        "first_name": "PHILIP",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "4112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33693000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew C Kinkade, DPT
• Cassandra Jean Lynn Kinnard, LMT
• Denise Kirk, RRT
• Mitchell Robert Klement, M.D
• Meghan Victoria Klinck, PA-C
• Patrick N Koenig, M.D.
• Hannah Marie Kohlmetz, LCMHCA, LPC-IT
• Maria Kohlwey, LAT
• Melissa Ann Kohnert, LCSW
• Stephanie Kosidowski, PT

• Dentist in Pewaukee, WI
• Providers in Pewaukee, WI by specialty
• Dentist in Wisconsin

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.