Laura Lynn Koon, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110-003378 Issued in VA

Practice address

8266 Atlee Rd Ste 224
Mechanicsville, VA 23116-1813

Phone

(804) 454-7240

NPI assigned

Oct 20, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VA

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

Physician Assistant

State licenses

Practice roles

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.

• Integrative Regional Medical Center, P.C.

  • Nurse Practitioner
  • Mechanicsville, VA
  • NPI 1386187540
  Medicare reassignment
• Virginia Pain and Restorative Health

  • Pain Medicine (Anesthesiology) Physician
  • Richmond, VA
  • NPI 1013732833
  Medicare reassignment
• Midlothian Medi LLC

  • Family Medicine Physician
  • Midlothian, VA
  • NPI 1760051502
  NPD (past)

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670112000000",
    "number": "1386970747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3730 RIVERMIST TER",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231133740",
            "telephone_number": "804-613-8309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8266 ATLEE RD STE 224",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231161813",
            "telephone_number": "804-454-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOON",
        "first_name": "LAURA",
        "middle_name": "LYNN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2022-12-04",
        "certification_date": "2022-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110-003378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699850032",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0110003378",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "P00869721",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marie Rodgers Knorr, MD
• Loretta M Knott, RPH
• Catherine Rea Knox, BCABA
• Laura Kohlroser, SLP
• Sarah Kolster, LPTA
• Ashley Koppelman
• Kathryn L Kothe, WHNP
• KPNP
• Joseph D Krajewski, PA-C
• Debbie Lynn Kramer

• Medical Physician Assistant in Mechanicsville, VA
• Providers in Mechanicsville, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2022; 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.