Jodi Gayle Koenig, PNP-AC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP120917 Issued in TX

Practice address

121 Dennis Dr
Seguin, TX 78155-0402

Phone

(308) 372-8981

Fax

(830) 372-8984

NPI assigned

Sep 14, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkoenig566679@christushealth.direct-ci.net
• Direct secure messaging: jkoenig453022@direct.integrisok.com

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.

• Geronimo Village Pediatrics, PLLC

  • Primary Care Clinic/Center
  • Seguin, TX
  • NPI 1356800791
  NPD Authorized official
• Baylor College of Medicine

  • Pediatrics Physician
  • San Antonio, TX
  • NPI 1285079764

  TX

  Medicare reassignment

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1346522596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9223 HUBER RD",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781551973",
            "telephone_number": "830-379-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 DENNIS DR",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781550402",
            "telephone_number": "308-372-8981",
            "fax_number": "830-372-8984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 N Santa Rosa",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782073108",
            "country_code": "US",
            "telephone_number": "210-704-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "JODI",
        "middle_name": "GAYLE",
        "credential": "PNP-AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-14",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP120917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "339554303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martha Danielle King
• Sarah Nicole Kiniment, APRN-CNP
• John Christopher Kipple, APRN, MS, CRNA
• Kirchner Womens Clinic PLLC
• Alyson J. Kirchner, M.D.
• Tara Kohlenberg
• Andrea Rose Kovach, PT
• Aileen Kronewetter, COTA
• Yu Jie Jack Kuo, M.D.
• Denver W Lackorn, D.D.S.

• Pediatric Nurse Practitioner in Seguin, TX
• Providers in Seguin, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.