Karissa Lynn Koerner

Primary specialty

SpecialistTaxonomy code 174400000X

License

695120121 Issued in NY

Practice address

179 Spur Dr S
Bay Shore, NY 11706-3908

Phone

(631) 666-5762

NPI assigned

Aug 7, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1073945580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 SPUR DR S",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117063908",
            "telephone_number": "631-666-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 SPUR DR S",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117063908",
            "telephone_number": "631-666-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOERNER",
        "first_name": "KARISSA",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-07",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "695120121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tashay Knight
• Margarete Grace Knudsen, MD
• Danielle Knuppel, NP
• Nancy R Ko, RPAC
• Julia Rose Koebert, PA-C
• Edward William Kolk, D.P.M.
• Lawrence Kopsick, D.O.
• Robert S Korn, MD
• Allison Marie Kornahrens, PMHNP
• John H Kraft, D.C

• Specialist in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.