Amanda Koon

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

2198 US 31 S
Manistee, MI 49660-9618

Phone

(231) 655-3146

NPI assigned

Jul 10, 2023

Sex

Female

Sole proprietor

No

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Manistee Benzie Community Mental Health

  • Community/Behavioral Health Agency
  • Manistee, MI
  • NPI 1063581205
  Medicare reassignment NPD
• Manistee Benzie Community Mental Health

  • Primary Care Clinic/Center
  • Manistee, MI
  • NPI 1366806432
  NPD

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1124706130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2198 US 31 S",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496609618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2198 US 31 S",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496609618",
            "telephone_number": "231-655-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOON",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen King
• Nicole King
• Jeffrey Elliott Kittle, M.D.
• Klaus P. Kutschke, M.D., P.C.
• Cheryl Ann Kobernik, LMSW
• Chelsey M Kott
• Patrick Hilary Kozlowski, LPC
• Theresa Ruth Kuhr, R.N.
• Klaus Peter Kutschke, M.D.
• Laina Laarman

• Clinical Social Worker in Manistee, MI
• Providers in Manistee, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.