Individual provider Active NPI

Frank Koe, MD

  • Family Medicine Physician
  • Byram, MS
National Provider Identifier
1366459976
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
07682 Issued in MS
Practice address
7300 S Siwell Rd
Byram, MS 39272-9772
Phone
(601) 373-1234
Fax
(601) 373-1397
NPI assigned
Aug 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 07682 MS Primary

Addresses

Primary practice location

7300 S Siwell Rd
Byram, MS 39272-9772

Mailing address

7300 S Siwell Rd
Byram, MS 39272-9772
Phone (601) 373-1234

Other identifiers 1

IdentifierTypeStateIssuer
0115971MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101118000720 MS Practitioner - Emergency Medicine 1456330190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
07682MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Intermed Corporation Family Medicine Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366459976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 S SIWELL RD",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392729772",
            "telephone_number": "601-373-1234",
            "fax_number": "601-373-1397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 S SIWELL RD",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392729772",
            "telephone_number": "601-373-1234",
            "fax_number": "601-373-1397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOE",
        "first_name": "FRANK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "07682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0115971",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Byram, MS

Sources for this page

Verify at the official NPI Registry.