Koinonia Dynamis Inc.

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

MH9044 Issued in FL

Legal business name

KOINONIA DYNAMIS INC.

Practice address

1734 Hiram St
Jacksonville, FL 32209-6105

Phone

(904) 354-6005

Fax

(904) 354-6005

NPI assigned

Apr 27, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Addris Blanche Vinson, LMHC, CRC

Title

Ceo

Phone

(904) 354-6005

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Koinonia Dynamis Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Koinonia Dynamis Inc.

  • Case Management Agency
  • Jacksonville, FL
  • NPI 1083858112
  NPD tax ID
• Koinonia Dynamisinc

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1730536772
  NPD tax ID

Practitioners 1

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

• Patricia Ann Simmons

  • Case Manager/Care Coordinator
  • Jacksonville, FL
  • NPI 1851528806
  NPD (past)

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240790400000",
    "number": "1366686958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1734 HIRAM ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096105",
            "telephone_number": "904-354-6005",
            "fax_number": "904-354-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1734 HIRAM ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096105",
            "telephone_number": "904-354-6005",
            "fax_number": "904-354-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOINONIA DYNAMIS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-27",
        "last_updated": "2009-04-27",
        "status": "A",
        "authorized_official_last_name": "VINSON",
        "authorized_official_first_name": "ADDRIS",
        "authorized_official_middle_name": "BLANCHE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-354-6005",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMHC, CRC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "FL",
            "license": "MH9044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285766840",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shontee M Kohn, CNA
• Stephanie Holmes Kohn, M.S.
• Jamie Kohrn, LMT
• Kenzo James Paul Koike, M.D.
• Koinonia Dynamis Inc.
• Koinonia Dynamisinc
• James Koivisto, PHARMD
• Kok-Tow NG, DDS., PA
• Erald Kola
• Elizabeth Ashley Kolankiewicz, RN

• Case Management Agency in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Case Management Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2009; 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.