Active NPI
Austin Koelker, PHARMD
- Pharmacist
- Austin, TX
National Provider Identifier
1548865181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 67879
- Practice address
- 2402 Guadalupe St Ste B
Austin, TX 78705-4843 - Phone
- (512) 474-2323
- NPI assigned
- Dec 2, 2020
- Last updated
- Sep 3, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 43250 | TN | |
| Pharmacist | 183500000X | 67879 | TX | Primary |
Addresses
Primary practice location
2402 Guadalupe St Ste B
Austin, TX 78705-4843
Mailing address
2402 Guadalupe St Ste B
Austin, TX 78705-4843
Phone (512) 474-2323
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 Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67879 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Current | Accepting new patients | |
| CVS Pharmacy Inc | Past | Accepting new patients | |
| CVS Pharmacy Inc | Past | Accepting new patients |
Locations
2402 Guadalupe St
Ste B
Austin, TX 78705
Phone (512) 474-2323
Organizations & group practices 3
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": "1606867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630627200000",
"number": "1548865181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2402 GUADALUPE ST STE B",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787054843",
"telephone_number": "512-474-2323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2402 GUADALUPE ST STE B",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787054843",
"telephone_number": "512-474-2323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOELKER",
"first_name": "AUSTIN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-02",
"last_updated": "2021-09-03",
"certification_date": "2021-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "43250",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "67879",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.