Active NPI
Lance Koenig, ED.S.
- School Psychologist
- Madison, SD
National Provider Identifier
1275080889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 72674-0
- Practice address
- 820 North Washington Ave
Plec Dakota State University
Madison, SD 57042 - Phone
- (605) 256-5555
- NPI assigned
- Sep 1, 2016
- Last updated
- Sep 1, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 72674-0 | SD | Primary |
Addresses
Primary practice location
820 North Washington Ave
Plec Dakota State University
Madison, SD 57042
Mailing address
820 North Washington Ave
Plec Dakota State University
Madison, SD 57042
Phone (605) 256-5555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 72674-0 | SD | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472688000000",
"number": "1275080889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 NORTH WASHINGTON AVE",
"address_2": "PLEC DAKOTA STATE UNIVERSITY",
"city": "MADISON",
"state": "SD",
"postal_code": "57042",
"telephone_number": "605-256-5555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 NORTH WASHINGTON AVE",
"address_2": "PLEC DAKOTA STATE UNIVERSITY",
"city": "MADISON",
"state": "SD",
"postal_code": "57042",
"telephone_number": "605-256-5555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOENIG",
"first_name": "LANCE",
"credential": "ED.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-01",
"last_updated": "2016-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "SD",
"license": "72674-0",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.