Individual provider Active NPI

John Aaron Kohler Sr., MD, MBA

  • Pediatrics Physician
  • Wilmington, NC
National Provider Identifier
1497045413
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2014-00165 Issued in NC
Practice address
2131 S 17TH St
Wilmington, NC 28401-7407
Phone
(910) 577-4749
NPI assigned
Apr 11, 2011
Last updated
Jan 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2014-00165 NC Primary
Neonatal-Perinatal Medicine Physician 2080N0001X 2014-00165 NC

Addresses

Primary practice location

2131 S 17TH St
Wilmington, NC 28401-7407

Mailing address

317 Western Blvd
Jacksonville, NC 28546-6379

Other identifiers 3

IdentifierTypeStateIssuer
19QDFOtherNCBCBS NC
NCX9620322OtherNCMEDICARE
1497045413MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170804000002 NC Practitioner - Pediatric Medicine 4183995459 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2014-00165NCMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NMG Health Services LLC CurrentSince Apr 29, 2024 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
Novant Health Medical Group Coastal Region, LLC Pediatrics CurrentSince Apr 29, 2024 Accepting new patients
New Hanover Medical Group PA Past Accepting new patients

Locations

2000 Brabham Ave
Jacksonville, NC 28546
Phone (910) 662-8765

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

Interoperability endpoints

  • Direct secure messaging: jkohler1236113@direct.novanthealth.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Onslow Memorial HospitalJacksonville, NC, CCN 340042 Hospital Corporate Officer Aug 14, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1497045413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 WESTERN BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017407",
            "telephone_number": "910-577-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLER",
        "first_name": "JOHN",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-11",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2014-00165",
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NC",
            "license": "2014-00165",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "19QDF",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "NCX9620322",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497045413",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.