Organization Active NPI

Joan M Koewler DPM PA

  • Foot & Ankle Surgery Podiatrist
  • Sarasota, FL
National Provider Identifier
1861642175
Registry record updated Feb 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO1696 Issued in FL
Legal business name
JOAN M KOEWLER DPM PA
Practice address
4157 Clark Rd
Sarasota, FL 34233-2403
Phone
(941) 923-4999
Fax
(941) 923-4998
NPI assigned
Sep 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2009

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

Authorized official

Name
Judy E Smith
Title
Office Manager
Phone
(941) 923-4999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X PO1696 FL Primary

Addresses

Primary practice location

4157 Clark Rd
Sarasota, FL 34233-2403

Mailing address

4157 Clark Rd
Sarasota, FL 34233-2403
Phone (941) 923-4999

Other identifiers 1

IdentifierTypeStateIssuer
87902OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081222000150 FL Part B Supplier - Clinic/Group Practice 1850461518 Receives reassigned benefits from 1 practitioner
Practice locations: Sarasota, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235347200000",
    "number": "1861642175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4157 CLARK RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342332403",
            "telephone_number": "941-923-4999",
            "fax_number": "941-923-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4157 CLARK RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342332403",
            "telephone_number": "941-923-4999",
            "fax_number": "941-923-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOAN M KOEWLER DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-23",
        "last_updated": "2009-02-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "941-923-4999"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO1696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "87902",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.