Individual provider Active NPI

Karla Renee Kossler, M.D.

  • Obstetrics & Gynecology Physician
  • Bloomington, IL
National Provider Identifier
1780876961
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036127444 Issued in IL
Practice address
326 Fairway Dr
Bloomington, IL 61701-3462
Phone
(309) 310-4596
NPI assigned
Aug 13, 2007
Last updated
Aug 31, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2007016230 MO
Obstetrics & Gynecology Physician 207V00000X 036127444 IL Primary

Addresses

Primary practice location

326 Fairway Dr
Bloomington, IL 61701-3462

Mailing address

326 Fairway Dr
Bloomington, IL 61701-3462
Phone (309) 451-9595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20130207000352 IL Practitioner - Obstetrics/Gynecology 0143474767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Southern Illinois University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

326 Fairway Dr
Bloomington, IL 61701-3462
Phone (309) 451-9595

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2007016230MOMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1780876961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 FAIRWAY DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013462",
            "telephone_number": "309-451-9595",
            "fax_number": "309-451-9583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 FAIRWAY DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013462",
            "telephone_number": "309-310-4596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSSLER",
        "first_name": "KARLA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2007016230",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036127444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.