Individual provider Active NPI

James P Koller, M.D.

  • Internal Medicine Physician
  • Columbia, MO
National Provider Identifier
1851338586
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
110284 Issued in MO
Practice address
101 S Fairview Rd
Columbia, MO 65203-7637
Phone
(573) 882-4464
Fax
(573) 884-8142
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 110284 MO Primary

Addresses

Primary practice location

101 S Fairview Rd
Columbia, MO 65203-7637

Mailing address

PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300

Other identifiers 4

IdentifierTypeStateIssuer
111029OtherMOBLUE SHIELD/BLUE CHOICE
286085OtherMOHEALTHLLINK
409667OtherMOUNITED HEALTHCARE
208291203MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MUDOCREFERRAL@direct.health.missouri.edu Direct Curators of the University of Missouri

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20070614000025 MO Practitioner - Internal Medicine 8729186721 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Missouri, Columbia School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Curators of the University of MissouriGroup PAC ID 4486759560, 1,108 clinicians

Practice addresses (Care Compare)

101 S Fairview Rd
Columbia, MO 65203-7637
Phone (573) 882-4464

Hospital & facility affiliations

  • University of Missouri Health Care Hospital, Columbia, MO, CCN 260141

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
58.17
Promoting interoperability
100
Improvement activities
40
Cost
75.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
110284MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Curators of the University of Missouri CurrentSince May 24, 2007 Accepting new patients
The Curators of the University of Missouri CurrentSince May 24, 2007 Accepting new patients

Locations

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

1 Hospital Dr
Columbia, MO 65201
Phone (573) 882-2568

101 S Fairview Rd
Columbia, MO 65203
Phone (573) 882-1095

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1851338586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S FAIRVIEW RD",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652037637",
            "telephone_number": "573-882-4464",
            "fax_number": "573-884-8142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLER",
        "first_name": "JAMES",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "110284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD/BLUE CHOICE",
            "identifier": "111029",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLLINK",
            "identifier": "286085",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "409667",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208291203",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals.",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "DIRECT",
            "address_1": "1 Hospital Dr",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652120001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.