Asha Kodwani, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2008012505 Issued in MO

Practice address

915N Grand Blvd
Saint Louis, MO 63106-1621

Phone

(314) 652-4100

NPI assigned

Sep 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• County of St Louis Division of Fiscal Management

  • Federally Qualified Health Center (FQHC)
  • Berkeley, MO
  • NPI 1184519506
  NPD (past)

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439510400000",
    "number": "1679769178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2522 BARRETT GLEN CT",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630217812",
            "telephone_number": "314-909-7803",
            "fax_number": "314-909-7803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915N GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631061621",
            "telephone_number": "314-652-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODWANI",
        "first_name": "ASHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2015-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2008012505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679769178",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsie Chizuko Kodama, MD
• Rohan Kodgule, MD
• Shammah Kodjo-Soroh, MD
• Holly Hiroko Kodner, MD
• Ira Joe Kodner, MD
• Jennifer Anne Koeb, ACNP
• Mary Colleen Koebbe, RN
• Rikki Lynn Koebler, DO
• Jodi Koechner, ARNP
• Judith Ann Koehler, M.A., LPC, NCC

• Internal Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.