Active NPI
Paul Koerner
- Pharmacist
- Orlando, FL
National Provider Identifier
1023565066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60674220
- Practice address
- 9600 Parksouth CT Ste 120
Orlando, FL 32837-6424 - Phone
- (877) 453-4566
- NPI assigned
- Sep 7, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH60674220 | WA | Primary |
Addresses
Primary practice location
9600 Parksouth CT Ste 120
Orlando, FL 32837-6424
Mailing address
2400 S Jackson St
Seattle, WA 98144-2364
Phone (206) 329-6850
Other practice location 1
2400 S Jackson St
Seattle, WA 98144-2364
Phone (206) 329-6850
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH60674220 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Wal-Mart Stores East LP | Past | Accepting new patients |
Organizations & group practices 3
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606953600000",
"number": "1023565066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 S JACKSON ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981442364",
"telephone_number": "206-329-6850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9600 PARKSOUTH CT STE 120",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328376424",
"telephone_number": "877-453-4566"
}
],
"practiceLocations": [
{
"address_1": "2400 S Jackson St",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981442364",
"country_code": "US",
"telephone_number": "206-329-6850",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOERNER",
"first_name": "PAUL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-07",
"last_updated": "2020-12-03",
"certification_date": "2020-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60674220",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.