NPIMap

Individual provider Active NPI

Warren Koontz, M.D.

  • Family Medicine Physician
  • Richmond, VA
National Provider Identifier
1023090289
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101048298 Issued in VA
Practice address
1800 Glenside Dr Ste 110
Richmond, VA 23226-3769
Phone
(804) 288-1800
Fax
(804) 288-0515
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0101048298 VA
Family Medicine Physician 207Q00000X 0101048298 VA Primary

Addresses

Primary practice location

1800 Glenside Dr Ste 110
Richmond, VA 23226-3769

Mailing address

1800 Glenside Dr
Suite 105
Richmond, VA 23226-3769
Phone (804) 288-0399

Other identifiers 4

IdentifierTypeStateIssuer
141499OtherVAANTHEM
1023090289MedicaidVA
110089873OtherVAMEDICARE RAILROAD
006011586MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090724000086 VA Practitioner - Family Practice 6800969197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Primary CareGroup PAC ID 2264420918, 65 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

1800 Glenside Dr
Suite 101
Richmond, VA 23226-3769
Phone (804) 288-3001

9642 Burke Lake Rd
Burke, VA 22015-3052
Phone (703) 543-7920

Hospital & facility affiliations

  • At Home Care Home health agency, Mechanicsvlle, VA, CCN 497493
  • Centerwell Home Health Home health agency, Richmond, VA, CCN 497424
  • James River Home Health Agency Home health agency, Richmond, VA, CCN 497706
  • Commonwealth Home Care Home health agency, Richmond, VA, CCN 497703
  • Amedisys Home Health Home health agency, Midlothian, VA, CCN 497538
  • Henrico Doctors' Hospital Hospital, Richmond, VA, CCN 490118
  • Bon Secours St Marys Hospital Hospital, Richmond, VA, CCN 490059
  • Medical College of Virginia Hospitals Hospital, Richmond, VA, CCN 490032
  • Bon Secours St Francis Medical Center Hospital, Midlothian, VA, CCN 490136
  • Sheltering Arms Institute Inpatient rehabilitation facility, Richmond, VA, CCN 493036

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Primary Care Family Medicine CurrentSince Dec 1, 2011 Accepting new patients
Commonwealth Primary Care Family Medicine Past Accepting new patients

Locations

7140 Hull Street Rd
Ste 101
North Chesterfield, VA 23235
Phone (804) 276-4141

9930 Independence Park Dr
Ste 101
Richmond, VA 23233
Phone (804) 290-0060

1800 Glenside Dr
Ste 110
Richmond, VA 23226
Phone (804) 288-1800

1800 Glenside Dr
Ste 105
Richmond, VA 23226
Phone (804) 288-0399

1800 Glenside Dr
Ste 101
Richmond, VA 23226
Phone (804) 248-3001

8923 Three Chopt Rd
Ste 101
Richmond, VA 23229
Phone (804) 288-0057

Interoperability endpoints

  • Direct secure messaging: warren.koontz@cpcva.eclinicaldirectplus.com

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 31

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1023090289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 GLENSIDE DR",
            "address_2": "SUITE 105",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263769",
            "telephone_number": "804-288-0399",
            "fax_number": "804-285-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 GLENSIDE DR STE 110",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263769",
            "telephone_number": "804-288-1800",
            "fax_number": "804-288-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONTZ",
        "first_name": "WARREN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101048298",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101048298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "141499",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023090289",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "110089873",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006011586",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.