Kenneth S Koenig, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

G63182 Issued in CA

Practice address

8935 Olney Park Dr
Redding, CA 96001-9717

Phone

(530) 246-1139

Fax

(530) 246-9958

NPI assigned

Apr 18, 2007

Last updated

Aug 11, 2020By the provider in NPPES

Sex

Male

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 CA

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

Specialty

Family Practice

Education

Loma Linda University School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center Redding Hospital, Redding, CA, CCN 050280
• Patients' Hospital of Redding Hospital, Redding, CA, CCN 050697
• Shasta Regional Medical Center Hospital, Redding, CA, CCN 050764

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Health

  dba Mercy Medical Center Redding

  • General Acute Care Hospital
  • Redding, CA
  • NPI 1477671535
  Care Compare affiliation
• James D. Tate, M.D.

  dba Patients Hospital of Redding

  • General Acute Care Hospital
  • Redding, CA
  • NPI 1942204490
  Care Compare affiliation
• Prime Healthcare Services - Shasta LLC

  • General Acute Care Hospital
  • Redding, CA
  • NPI 1205089026
  Care Compare affiliation

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1396961470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 491836",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960491836",
            "telephone_number": "530-246-1139",
            "fax_number": "530-246-9958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8935 OLNEY PARK DR",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960019717",
            "telephone_number": "530-246-1139",
            "fax_number": "530-246-9958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "KENNETH",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G63182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G631820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Leeann Knouse, DPT
• Malinda Kay Knowles, NP
• Charity Jane Knox, NP
• Thomas James Knutson, MD
• Pieter Jacobus Koekemoer, RPH
• Lissa Jenat Koenig
• Yolanda Koenig
• Alyson Reynolds Kohl, MFT
• Vahini L Koka, DO
• Sussan Kokinda

• General Practice Physician in Redding, CA
• Providers in Redding, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.