Individual provider Active NPI

Joyce Marie Koerber, PA

  • Medical Physician Assistant
  • Vancouver, WA
National Provider Identifier
1114229374
Registry record updated May 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA60346640 Issued in WA
Practice address
210 SE 136TH Ave
Vancouver, WA 98684-6930
Phone
(360) 944-9889
Fax
(360) 944-9686
NPI assigned
Nov 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA153162 OR
Medical Physician Assistant 363AM0700X PA60346640 WA Primary

Addresses

Primary practice location

210 SE 136TH Ave
Vancouver, WA 98684-6930

Mailing address

210 SE 136TH Ave
Vancouver, WA 98684-6930
Phone (360) 944-9889

Other identifiers 1

IdentifierTypeStateIssuer
500633505MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110121000516 OR Practitioner - Physician Assistant 6709065832 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: joyce.koerber.1@14979.direct.athenahealth.com
  • Direct secure messaging: joyce.koerber@compass.ikm.direct-ci.com

Organizations & group practices 1

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": "1290297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525219200000",
    "number": "1114229374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 SE 136TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846930",
            "telephone_number": "360-944-9889",
            "fax_number": "360-944-9686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SE 136TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846930",
            "telephone_number": "360-944-9889",
            "fax_number": "360-944-9686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOERBER",
        "first_name": "JOYCE",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-21",
        "last_updated": "2018-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA153162",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60346640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500633505",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.