Dexter D Koons MD PC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

DEXTER D KOONS MD PC

Practice address

400 W 16TH St
Pueblo, CO 81003-2745

Phone

(719) 320-3515

Fax

(719) 543-1309

NPI assigned

Apr 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Dexter D Koons, M.D.NPI 1528068228

Title

Owner

Phone

(719) 296-6872

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dexter D Koons, M.D.

  • Neurological Surgery Physician
  • Pueblo, CO
  • NPI 1528068228
  Authorized official Same address or phone
• Jay A Balestrieri, NP

  • Nurse Practitioner
  • Pueblo, CO
  • NPI 1063554426
  NPD (past)
• Lucas R Derting, PA-C

  • Physician Assistant
  • Pueblo, CO
  • NPI 1306846381
  NPD (past)
• Dante Oliver Langston, PA

  • Medical Physician Assistant
  • Colorado Springs, CO
  • NPI 1669464038
  NPD (past)

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478736000000",
    "number": "1336102086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8561",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810088561",
            "telephone_number": "719-320-3515",
            "fax_number": "719-543-1309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 16TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032745",
            "telephone_number": "719-320-3515",
            "fax_number": "719-543-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEXTER D KOONS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2016-11-10",
        "status": "A",
        "authorized_official_last_name": "KOONS",
        "authorized_official_first_name": "DEXTER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-296-6872",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04013876",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Devan
• Quinn Alyse Devinney, PHARMD.
• Dylan B Devries, PA
• Bryan S Dewar, LMT
• Darcelle J Dewitt, MA, RP
• Hardeep Dholiya
• Diana Smith Psychiatric Mental Health Nurse Practitioner LLC (Parkview medical)
• Desyre Diaz, PSYD
• Stacey Diaz, RN
• Natika Diderickson

• Specialist in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.

Verify at the official NPI Registry.