Individual provider Active NPI

David A Koehler Jr., M.D.

  • Family Medicine Physician
  • Evansville, IN
National Provider Identifier
1801973086
Registry record updated Sep 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01047265A Issued in IN
Practice address
310 W Iowa St
Evansville, IN 47710-1724
Phone
(812) 450-7419
Fax
(812) 450-6760
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01047265A IN Primary

Addresses

Primary practice location

310 W Iowa St
Evansville, IN 47710-1724

Mailing address

PO Box 1510
Evansville, IN 47706-1510
Phone (812) 450-7419

Other identifiers 1

IdentifierTypeStateIssuer
200103830CMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20031124000486 IN Practitioner - Family Practice 4385548031 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Hospital, Inc Family Medicine CurrentSince Mar 1, 2015 Accepting new patients
Deaconess Hospital Inc CurrentSince Jan 1, 2006 Accepting new patients
Deaconess Hospital, Inc Family Medicine Current Accepting new patients
Deaconess Hospital, Inc Family Medicine Past Accepting new patients
Family Medicine Associates-Southern Indiana , P.C. Family Medicine Past Accepting new patients

Locations

415 W Columbia St
#110
Evansville, IN 47710
Phone (812) 450-3363

415 W Columbia St
#100
Evansville, IN 47710
Phone (812) 450-6200

310 W Iowa St
Evansville, IN 47710
Phone (812) 450-6200

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Deaconess Clinic IPetersburg, IN, CCN 153843 Rural health clinic Corporate Director Jan 1, 2012

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252540800000",
    "number": "1801973086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-450-7419",
            "fax_number": "812-450-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W IOWA ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101724",
            "telephone_number": "812-450-7419",
            "fax_number": "812-450-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHLER",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2009-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01047265A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200103830C",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.