Organization Active NPI

David E Konn MD PS

  • Cardiovascular Disease Physician
  • Aberdeen, WA
National Provider Identifier
1225368285
Registry record updated Jan 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD00024563 Issued in WA
Legal business name
DAVID E KONN MD PS
Practice address
1606 Simpson Ave
Aberdeen, WA 98520-4608
Phone
(360) 533-4442
Fax
(360) 533-1060
NPI assigned
Jan 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2010

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

Authorized official

Name
Dr. David Eric Konn, M.D.
Title
President
Phone
(360) 533-4442

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X MD00024563 WA Primary

Addresses

Primary practice location

1606 Simpson Ave
Aberdeen, WA 98520-4608

Mailing address

1606 Simpson Ave
Aberdeen, WA 98520-4608
Phone (360) 533-4442

Other identifiers 1

IdentifierTypeStateIssuer
1032572MedicaidWA

National Provider Directory

National Provider Directory

Locations

1606 Simpson Ave
Aberdeen, WA 98520
Phone (360) 533-4442

NPI Registry JSON

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263340800000",
    "number": "1225368285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 SIMPSON AVE",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985204608",
            "telephone_number": "360-533-4442",
            "fax_number": "360-533-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 SIMPSON AVE",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985204608",
            "telephone_number": "360-533-4442",
            "fax_number": "360-533-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID E KONN MD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-13",
        "last_updated": "2010-01-13",
        "status": "A",
        "authorized_official_last_name": "KONN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-533-4442",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD00024563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1032572",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; 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.