James Fletcher Koon, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

18339 Issued in SC

Practice address

206 S Matson St
Kershaw, SC 29067-1506

Phone

(803) 475-1156

Fax

(803) 475-1128

NPI assigned

Dec 23, 2005

Last updated

Aug 5, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Medical University of South Carolina College of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charleston Carenow Urgent Care LLCGroup PAC ID 3274893359, 72 clinicians

Medcare Express - North Charleston LLCGroup PAC ID 7618074899, 69 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medcare Express - North Charleston LLC

  dba Medcare Urgent Care

  • Urgent Care Clinic/Center
  • Charleston, SC
  • NPI 1457579617
  Medicare reassignment Care Compare group NPD
• Anmed Urgent Care LLC

  dba AnMed Urgent Care

  • Urgent Care Clinic/Center
  • Anderson, SC
  • NPI 1467289637
  Medicare reassignment NPD
• Charleston Carenow Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Goose Creek, SC
  • NPI 1093248288
  Care Compare group NPD
• Medcare Urgent Care Center - Anderson LLC

  • Urgent Care Clinic/Center
  • Anderson, SC
  • NPI 1689004095
  NPD
• Lancaster Clinic Corp

  • Family Medicine Physician
  • Kershaw, SC
  • NPI 1760678841
  NPD (past)
• Summerton Family Medicine LLC

  • Family Medicine Physician
  • Summerton, SC
  • NPI 1093707416
  NPD (past)

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217894400000",
    "number": "1093792608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S MATSON ST",
            "city": "KERSHAW",
            "state": "SC",
            "postal_code": "290671506",
            "telephone_number": "803-475-1156",
            "fax_number": "803-475-1128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S MATSON ST",
            "city": "KERSHAW",
            "state": "SC",
            "postal_code": "290671506",
            "telephone_number": "803-475-1156",
            "fax_number": "803-475-1128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOON",
        "first_name": "JAMES",
        "middle_name": "FLETCHER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2008-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "18339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAROLINA CARE",
            "identifier": "0141069",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH",
            "identifier": "20071782",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "000000229650",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01153584",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T24079",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RETIRED RR MEDICARE",
            "identifier": "080179118",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "A8973",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEECHSTREET",
            "identifier": "21149333031",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5532095",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPNI",
            "identifier": "8874326",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3091345",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John F Zeedick MD Inc
• Robin D Johnson, DENTIST
• Kershaw Counseling, LLC
• Kershaw Family Medicine Associates LLC
• Kershaw Family Pharmacy
• Lancaster Clinic Corp (Palmetto Family Medicine of Kershaw)
• Lancaster Clinic Corp
• Chineze Catherine Maduike
• James Jefferson McDowell Jr., OD
• Providence Physician Practices LLC

• Family Medicine Physician in Kershaw, SC
• Providers in Kershaw, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.