Active NPI
David A Koehler Jr., M.D.
- Family Medicine Physician
- Evansville, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01047265A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200103830C | Medicaid | IN |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deaconess Hospital, Inc | Family Medicine | Current | Accepting new patients |
| Deaconess Hospital Inc | Current | 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.
| Facility | Type | Role | Since |
|---|---|---|---|
| Deaconess Clinic I | 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.
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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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.