Active NPI
Thomas Koontz, D.C.
- Rehabilitation Chiropractor
- Germantown, TN
National Provider Identifier
1184747271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- DC0000001115
- Practice address
- 1996 Exeter Rd
Germantown, TN 38138-3949 - Phone
- (901) 362-2800
- Fax
- (901) 624-9782
- NPI assigned
- Apr 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | DC0000001115 | TN | Primary |
Addresses
Primary practice location
1996 Exeter Rd
Germantown, TN 38138-3949
Mailing address
PO Box 381408
Germantown, TN 38183-1408
Phone (901) 362-2800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3084009 | Other | TN | BLUECROSS BLUESHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040126000904 | TN | Practitioner - Chiropractic | 2062314347 | Practice locations: Germantown, TN |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC0000001115 | TN | MD | Rehabilitation Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184747271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 381408",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381831408",
"telephone_number": "901-362-2800",
"fax_number": "901-624-9782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1996 EXETER RD",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381383949",
"telephone_number": "901-362-2800",
"fax_number": "901-624-9782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOONTZ",
"first_name": "THOMAS",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "TN",
"license": "DC0000001115",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "3084009",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Germantown, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.