SHANNON MICHELLE KOEHLER MD PHD NPI 1710114178

NPI Information

NPI: 1710114178
Provider Name: SHANNON MICHELLE KOEHLER, MD, PHD
Classification: Surgery - 2086S0120X
Entity Type: Individual

Specialization: Pediatric Surgery

PECOS Registration: Yes

Address:
9000 W WISCONSIN AVE
PEDIATRIC SURGERY
MILWAUKEE, WI
ZIP 53226
Phone: (414) 266-6550
Get Directions

Shannon Michelle Koehler, MD, PHD is a pediatric surgery surgery in Milwaukee, WI. The provider is a surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. Shannon Michelle Koehler, MD, PHD NPI is 1710114178. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

9000 W WISCONSIN AVE
PEDIATRIC SURGERY
MILWAUKEE, WI
ZIP 53226-874
Phone: (414) 266-6550
Fax: (414) 266-6579

The NPI 1710114178 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/12/2009 and was last updated on 7/3/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208600000X	Surgery		MDR-5733	HAWAII	No
2	2086S0120X	Surgery	Pediatric Surgery	62385	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1710114178	MEDICAID	WISCONSIN
2	K400143681	MEDICARE PIN	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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