Active NPI
Daniel Gerard Kohm, MD
- Gastroenterology Physician
- Jacksonville, FL
National Provider Identifier
1649233172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- ME53041
- Practice address
- 4800 Belfort Road
Jacksonville, FL 32256-6004 - Phone
- (904) 398-7205
- NPI assigned
- Apr 7, 2006
- 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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | ME53041 | FL | Primary |
Addresses
Primary practice location
4800 Belfort Road
Jacksonville, FL 32256-6004
Mailing address
4800 Belfort Road
Jacksonville, FL 32256-6004
Phone (904) 398-7205
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 276078900 | Medicaid | FL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jax Anesthesia Providers LLC | Past | Accepting new patients | |
| St Louis Gastroenterology Consultants PC | Gastroenterology | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Jacksonville, FL
- NPI 1245271154
-
- Gastroenterology Physician
- St Louis, MO
- NPI 1639236136
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474329600000",
"number": "1649233172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4800 BELFORT ROAD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322566004",
"telephone_number": "904-398-7205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 BELFORT ROAD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322566004",
"telephone_number": "904-398-7205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHM",
"first_name": "DANIEL",
"middle_name": "GERARD",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-07",
"last_updated": "2016-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "FL",
"license": "ME53041",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "276078900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.