Terren Burgess Koles, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

35050061K Issued in OH

Practice address

2912 Springboro Rd
Suite
Moraine, OH 45439-1674

Phone

(513) 695-1468

Fax

(513) 695-2941

NPI assigned

Dec 28, 2006

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

Not listed in the public Medicare enrollment file

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.

• Providence Medical Group

  • Podiatrist
  • Moraine, OH
  • NPI 1811304595
  NPD (past)
• Warren County

  • Public Health or Welfare Agency
  • Lebanon, OH
  • NPI 1326108838
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334275200000",
    "number": "1699831693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2912 SPRINGBORO RD",
            "address_2": "SUITE 201",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391674",
            "telephone_number": "937-885-1927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2912 SPRINGBORO RD",
            "address_2": "SUITE",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391674",
            "telephone_number": "513-695-1468",
            "fax_number": "513-695-2941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLES",
        "first_name": "TERREN",
        "middle_name": "BURGESS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2012-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "35050061K",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2933179",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Kline, MA, LPCC-S
• April Knick
• Shamea Knight
• Lindsay Maria Koeller
• Anita C Koerner, MSW, LISW-S
• Cassie Kooser, LPC
• Sarah R. Kramer
• Kristy Michelle Krebs
• Sheena Marie Kreitzer
• Yvonne Victoria Kuhn, PA-C

• General Practice Physician in Moraine, OH
• Providers in Moraine, OH by specialty
• General Practice Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.