Individual provider Active NPI

Kathrin Koehler, PSYD

  • Clinical Psychologist
  • West Liberty, OH
National Provider Identifier
1770114647
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4949 Issued in OH
Practice address
6557 US Highway 68 S
West Liberty, OH 43357-9536
Phone
(937) 206-3458
NPI assigned
Jan 30, 2020
Last updated
Feb 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4949 OH Primary

Addresses

Primary practice location

6557 US Highway 68 S
West Liberty, OH 43357-9536

Mailing address

4674 Hominy Ridge Rd
Springfield, OH 45502-8031

Other identifiers 1

IdentifierTypeStateIssuer
4949OtherSTATE MEDICAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Springfield Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20200505003024 OH Practitioner - Psychiatry 7416388541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Wright State University Boonshoft School of Medicine, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4674 Hominy Ridge Rd
Springfield, OH 45502-8031
Phone (937) 206-3458

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4949OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kathrin a Koehler Clinical CurrentSince Feb 17, 2020 Accepting new patients

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, 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": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1770114647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4674 HOMINY RIDGE RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455028031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6557 US HIGHWAY 68 S",
            "city": "WEST LIBERTY",
            "state": "OH",
            "postal_code": "433579536",
            "telephone_number": "937-206-3458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHLER",
        "first_name": "KATHRIN",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "4949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "4949",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Springfield",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6557 US Highway 68 S",
            "city": "West Liberty",
            "state": "OH",
            "country_code": "US",
            "postal_code": "433579536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Liberty, OH

Sources for this page

Verify at the official NPI Registry.