Individual provider Active NPI

Nichol Kobler

  • Marriage & Family Therapist
  • Land O Lakes, FL
National Provider Identifier
1548845225
Registry record updated Apr 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4032 Issued in MN
Practice address
17034 Kettle LN Apt 313
Land O Lakes, FL 34638-0063
Phone
(630) 726-2402
NPI assigned
Mar 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT4051 FL
Marriage & Family Therapist 106H00000X 4032 MN Primary

Addresses

Primary practice location

17034 Kettle LN Apt 313
Land O Lakes, FL 34638-0063

Mailing address

1801 American Blvd E Ste 8
Bloomington, MN 55425-1230
Phone (612) 767-7222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231123000034 FL Practitioner - Marriage and Family Therapist 5294183687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dna Comprehensive Therapy Services LLCGroup PAC ID 2860619632, 446 clinicians

Practice addresses (Care Compare)

11349 Cortez Blvd
Brooksville, FL 34613-5404
Phone (239) 223-2751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4032MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dna Comprehensive Therapy Services, LLC CurrentSince Jan 1, 2024 Accepting new patients
Bonita Springs Retirement Village, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Fraser Child and Family Center CurrentSince Oct 9, 2023 Accepting new patients
Fraser PastSince Mar 1, 2021 Accepting new patients

Locations

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

11349 Cortez Blvd
Spring Hill, FL 34613
Phone (352) 597-0022

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

1801 American Blvd E
Ste 8
Minneapolis, MN 55425
Phone (612) 400-6173

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1615680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648857600000",
    "number": "1548845225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 AMERICAN BLVD E STE 8",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251230",
            "telephone_number": "612-767-7222",
            "fax_number": "612-728-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17034 KETTLE LN APT 313",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346380063",
            "telephone_number": "630-726-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBLER",
        "first_name": "NICHOL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-14",
        "last_updated": "2022-04-02",
        "certification_date": "2022-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT4051",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Land O Lakes, FL

Sources for this page

Verify at the official NPI Registry.