JAXON ROBERT KOEHL DC
NPI 1922980028
Chiropractor in Fort Wayne, IN

Q: What is Jaxon Koehl's NPI number?

The NPI number for Jaxon Koehl is 1922980028. It was assigned to this individual provider in the NPPES registry on July 22, 2025.

Q: What is Jaxon Koehl's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Q: When was this NPI record last updated?

The NPPES record for Jaxon Koehl was last updated on July 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 22, 2025

1114 W COOK RD, FORT WAYNE, IN 46825(260) 483-5588(260) 489-1819 Get Directions Write a Review

NPPES record last updated: July 22, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jaxon Robert Koehl Dc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAXON ROBERT KOEHL DC (NPI 1922980028) is an individual chiropractor in Fort Wayne, Indiana, licensed in Indiana (08003529A) and active in the NPI registry since July 2025. He is a graduate of Logan College Of Chiropractic (2025).

NPPES Registry Identity

NPI1922980028

Entity TypeIndividualMale

Primary Taxonomy111N00000X

Provider Legal NameJAXON ROBERT KOEHLCredential: DC

Location Address1114 W COOK RDFort Wayne, IN 46825-3214

Mailing Address1114 W Cook RdFort Wayne, IN 46825-3214 · (260) 483-5588 · Fax (260) 489-1819

Phone(260) 483-5588

Fax(260) 489-1819

Sole ProprietorNo

Medical School CMSLogan College Of ChiropracticGraduated 2025

Enumeration DateJuly 22, 2025

NPPES CertifiedJuly 22, 2025

✔ NPI 1922980028 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

License✔ Licensed in IN · 08003529A

Definition

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

1114 W COOK RD, Fort Wayne, IN 46825

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jaxon Robert Koehl Dc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4183192792

PECOS Enrollment IDI20260501001258

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TRENTON G BOGGS DC

Chiropractor