Active NPI
Kristopher Kohlbacher, M.D.
- Public Health & General Preventive Medicine Physician
- Fort Hood, TX
National Provider Identifier
1477967222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- 01075733A
- Practice address
- 36065 Santa Fe Ave
Fort Hood, TX 76544-5060 - Phone
- (254) 288-1056
- NPI assigned
- Jun 19, 2014
- 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 |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | 01075733A | IN | Primary |
Addresses
Primary practice location
36065 Santa Fe Ave
Fort Hood, TX 76544-5060
Mailing address
9040 Fitzsimmons Dr
Joint Base Lewis McChord, WA 98431-1000
Phone (253) 968-0354
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01075733A | IN | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567468800000",
"number": "1477967222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9040 FITZSIMMONS DR",
"city": "JOINT BASE LEWIS MCCHORD",
"state": "WA",
"postal_code": "984311000",
"telephone_number": "253-968-0354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36065 SANTA FE AVE",
"city": "FORT HOOD",
"state": "TX",
"postal_code": "765445060",
"telephone_number": "254-288-1056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHLBACHER",
"first_name": "KRISTOPHER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-19",
"last_updated": "2019-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "IN",
"license": "01075733A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Hood, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.