John H. Koewler, PH.D.
Individual provider Active NPI Psychologist · Farmington, NM
NPI 1811907553 · NPPES record last updated May 29, 2013
Key facts
- NPI
- 1811907553
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 501 (NM)
- Practice address
- 555 S Schwartz Ave
Farmington, NM 87401-5955 - Phone
- (505) 327-4998
- NPI assigned
- Aug 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- University of Miami, LM Miller School of Medicine, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
555 S Schwartz Ave
Farmington, NM 87401-5955
Phone (505) 327-4998
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050922000561 | NM | Practitioner - Clinical Psychologist | 2668406307 |
Reassigns benefits to 1 organization Practice locations: Farmington, NM |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 501 | NM | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Juan Regional Medical Center Inc | Current | Accepting new patients | |
| San Juan Regional Medical Center Inc | Current |
Accepting new patients | |
| San Juan Regional Medical Center Inc | Current |
Accepting new patients |
Locations
1930 San Juan Blvd
Ste K
Farmington, NM 87401
Phone (505) 326-7679
555 S Schwartz Ave
Farmington, NM 87401
Phone (505) 564-8073
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 501 | NM | Yes |
Addresses
Primary practice location
555 S Schwartz Ave
Farmington, NM 87401-5955
Mailing address
555 S Schwartz Ave
Farmington, NM 87401-5955
Phone (505) 327-4998
NPI Registry JSON
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369785600000",
"number": "1811907553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 S SCHWARTZ AVE",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874015955",
"telephone_number": "505-327-4998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 S SCHWARTZ AVE",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874015955",
"telephone_number": "505-327-4998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOEWLER",
"first_name": "JOHN",
"middle_name": "H.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2013-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NM",
"license": "501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington, NM
- Dennis R Kloberdanz
- Amy Joanne Knackendoffel
- Knew Creation LLC
- Jasin E Knights
- Gregory Robert Knutsen
- Jeanne Marie Kofron
- Samrat Babu Koirala
- Edward Kompare
- Dawn J Koons
- Joseph Mani Korah
All providers in Farmington, NM · Psychologist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.