NPIMap

Organization Active NPI

Kermit Koontz Education Center

  • Community/Behavioral Health Agency
  • Fresno, CA
National Provider Identifier
1356760110
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
100091AN Issued in CA
Legal business name
KERMIT KOONTZ EDUCATION CENTER
Practice address
2822 E Floradora Ave
Fresno, CA 93703-3906
Phone
(559) 981-2143
NPI assigned
Apr 9, 2014
Organization subpart
Yes
Parent organization
DUNAMIS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 9, 2014

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

Authorized official

Name
Mr. Orlando GillamNPI 1962836676
Title
Chief Executive Officer
Phone
(559) 981-2143

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 100091AN CA Primary

Addresses

Primary practice location

2822 E Floradora Ave
Fresno, CA 93703-3906

Mailing address

2822 E Floradora Ave
Fresno, CA 93703-3906
Phone (559) 981-2143

Other identifiers 1

IdentifierTypeStateIssuer
1962637512OtherCAMEDI CAL

National Provider Directory

National Provider Directory
Tax ID family
Dunamisinc Group Home28 organizations share this tax ID, including this one
Part of
Dunamisinc Group Home

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397001600000",
    "number": "1356760110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2822 E FLORADORA AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937033906",
            "telephone_number": "559-981-2143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2822 E FLORADORA AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937033906",
            "telephone_number": "559-981-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERMIT KOONTZ EDUCATION CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DUNAMIS, INC",
        "enumeration_date": "2014-04-09",
        "last_updated": "2014-04-09",
        "status": "A",
        "authorized_official_last_name": "GILLAM",
        "authorized_official_first_name": "ORLANDO",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "559-981-2143",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "100091AN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "1962637512",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; 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.