JOHN M KOLLER (NPI# 1588721195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588721195 |
| Entity Type | Individual |
| Full Name | JOHN M KOLLER |
| Credential | M.D. |
| Practice Address |
202 Center Ave. Ste. 102 Kodiak AK 99615-1126 |
| Mailing Address |
Po Box 1126 Kodiak AK 99615-1126 |
| Practice Telephone | 9074866188 |
| Practice Fax Number | 9074866146 |
| Mailing Telephone | 9074866188 |
| Mailing Fax Number | 9074866146 |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2018-01-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | S3737 | AK | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 3737 | AK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE ID 6.29.09 - PRESENT | K162501 | 01 | |
| MEDICARE ID ( DEACTIVATED AFTER 5.16.09) | K151630 | 01 | |
| AK | MD10072 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699790691 | John J Koller | Chiropractor | 127 N 7th St, Suite A, Akron, PA 17501-1343 | 2006-07-12 |
| Street Address |
202 CENTER AVE. STE. 102 |
| City | KODIAK |
| State | AK |
| Zip Code | 99615-1126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144864232 | Linda Irene Dunlap | Spec/Tech, Pathology | 1915 E. Remanof Drive, Kodiak, AK 99615 | 2019-10-31 |
| 1639638190 | Stephanie Brenteson | Community Health Worker | 125 Airport Way, Akhiok, AK 99615 | 2019-03-14 |
| 1609351022 | Desiree Alexis Wheeler | Optometrist | 3450 E Rezanof Dr, Kodiak, AK 99615 | 2018-10-02 |
| 1417479072 | Elaine Loomis Olsen | Case Manager/Care Coordinator | 1111 Purtov St., Kodiak, AK 99615 | 2017-07-14 |
| 1750828414 | Mary Jean Francisco | Case Manager/Care Coordinator | 717 East Rezanof Drive, Kodiak, AK 99615 | 2017-01-19 |
| 1558818112 | Carolyn Hawes | Case Manager/Care Coordinator | 717 Rezanof Dr, Kodiak, AK 99615 | 2016-09-01 |
| 1285083683 | Amanda Wilson | Community Health Worker | 124 Akhiok Street, Akhiok, AK 99615 | 2016-06-07 |
| 1447612056 | Kailee Champion | Massage Therapist | 3449 Rezanof Drive East, Kodiak, AK 99615 | 2016-03-23 |
| 1376891069 | Krystyna Mcrobert | Technician, Other | Cape Sarichef Road Bldg N46, Rockmore King Clinic, Kodiak, AK 99615 | 2012-08-28 |
| 1164778619 | Mark Anthony Johnson | Pharmacist | 3449 Rezanof Drive, Kodiak, AK 99615 | 2012-08-01 |
| Find all providers in zip 99615 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285265181 | Kodiak Birth and Wellness, LLC | Family Medicine | 1527 Mission Rd, Kodiak, AK 99615-6507 | 2020-01-29 |
| 1962639617 | Paul A Forward | Family Medicine | 1915 Rezanof Dr E, Kodiak, AK 99615-6602 | 2009-06-19 |
| 1386765618 | Thomas Hugh Solenberger | Family Medicine | 1955 Marmot Dr, Kodiak, AK 99615-7233 | 2007-04-03 |
| 1538205307 | Kevin Creelman | Family Medicine | 104 Center Ave Ste 100, Kodiak, AK 99615-6393 | 2007-01-29 |
| 1225106263 | North Pacific Medical Center PC | Family Medicine | 104 Center Ave Suite 100, Kodiak, AK 99615 | 2006-11-30 |
| 1437104940 | Heidi Coryell Lowrey Baines | Family Medicine | 3449 E Rezanof Dr, Kodiak, AK 99615-6952 | 2006-05-23 |
| 1932172509 | Randall C Schick I | Family Medicine | Bldg N-46 Cape Sarichef, Kodiak, AK 99619-5002 | 2006-02-13 |
| 1831162825 | Laura Marie Walters | Family Medicine | 1911 E Rezanof Dr, Kodiak, AK 99615-6602 | 2006-02-09 |
| 1386629541 | Kevin Joseph Nolan | Family Medicine | 210b Albatross Ave, Kodiak, AK 99615-6806 | 2005-12-09 |
| 1659635225 | Cristin Moira O'grady | Family Medicine | 3449 E Rezanof Dr, Kodiak, AK 99615-6952 | 2012-06-28 |
| Find all providers in KODIAK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.