NPIMap

Individual provider Active NPI

Sophia Reagan Kohler, PA

  • Physician Assistant
  • Fayetteville, NC
National Provider Identifier
1548898117
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1319 Avon St
Fayetteville, NC 28304-4423
Phone
(910) 729-6552
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1319 Avon St
Fayetteville, NC 28304-4423

Mailing address

6820 Thames Dr
Fayetteville, NC 28306-2524
Phone (954) 604-5035

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200928001346 NC Practitioner - Physician Assistant 6901225861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Florida College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Id Care(R) - Infectious Diseases Specialty Practice PAGroup PAC ID 0345529988, 10 clinicians

Practice addresses (Care Compare)

1319 Avon St
Fayetteville, NC 28304-4423
Phone (910) 729-6552

Hospital & facility affiliations

  • Cape Fear Valley Medical Center Hospital, Fayetteville, NC, CCN 340028
  • Cape Fear Valley-Bladen County Hospital Hospital, Elizabethtown, NC, CCN 341315
  • Cape Fear Valley Hoke Hospital Hospital, Raeford, NC, CCN 340188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1548898117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6820 THAMES DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283062524",
            "telephone_number": "954-604-5035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 AVON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044423",
            "telephone_number": "910-729-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLER",
        "first_name": "SOPHIA",
        "middle_name": "REAGAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.