Individual provider Active NPI

David E Koronet, DC

  • Sports Physician Chiropractor
  • Mount Airy, MD
National Provider Identifier
1417067364
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
SO1418 Issued in MD
Practice address
602 Center St
#109
Mount Airy, MD 21771-7423
Phone
(301) 829-1717
Fax
(301) 829-5429
NPI assigned
Aug 30, 2006
Last updated
Mar 13, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X SO1418 MD Primary

Addresses

Primary practice location

602 Center St
#109
Mount Airy, MD 21771-7423

Mailing address

602 Center St
#109
Mount Airy, MD 21771-7423
Phone (301) 829-1717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120710000061 MD Practitioner - Chiropractic 6709041213 Practice locations: Mount Airy, MD

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1987
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

602 Ctr St
Suite 109
Mount Airy, MD 21771-7423
Phone (301) 829-1717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc 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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1417067364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 CENTER ST",
            "address_2": "#109",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217717423",
            "telephone_number": "301-829-1717",
            "fax_number": "301-829-5429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 CENTER ST",
            "address_2": "#109",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217717423",
            "telephone_number": "301-829-1717",
            "fax_number": "301-829-5429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORONET",
        "first_name": "DAVID",
        "middle_name": "E",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MD",
            "license": "SO1418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.