Joseph Koenigsmark, D.O.,M.B.A.

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

02001067A Issued in IN

Practice address

407 Zinnia Way
Shepherdsville, KY 40165-9663

Phone

(812) 288-8410

Fax

(812) 288-8409

NPI assigned

Dec 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

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 PracticeAlso: Addiction Medicine

Education

Midwestern University, Chicago College of Osteopathic Med, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acorn Addiction Centers LLC Dba Journey Road Treatment CentersGroup PAC ID 1951605161, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy, Master of Business Administration

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: journeyroadtreatmentcenter.josephkoenigsmark@135351.advancedmd-direct.com

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.

• Acorn Addiction Centers LLC Dba Journey Road Treatment Centers

  • Addiction Medicine (Family Medicine) Physician
  • Indianapolis, IN
  • NPI 1467824698

  IN, Single Specialty

  Medicare reassignment Care Compare group NPD
• Integrated Health of Indiana Inc

  • Family Medicine Physician
  • North Vernon, IN
  • NPI 1144666397

  IN, Single Specialty

  Medicare reassignment NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1437214731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3006 COBBLERS CROSSING RD",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471509457",
            "telephone_number": "502-640-4403",
            "fax_number": "812-725-8168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 ZINNIA WAY",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401659663",
            "telephone_number": "812-288-8410",
            "fax_number": "812-288-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIGSMARK",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.O.,M.B.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "IN",
            "license": "02001067A",
            "primary": true
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "IN",
            "license": "02001067A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02001067A",
            "primary": false
        },
        {
            "code": "202C00000X",
            "taxonomy_group": "",
            "desc": "Independent Medical Examiner",
            "state": "IN",
            "license": "02001067A",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "IN",
            "license": "02001067A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11452445",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64021611",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kiosk Medicine of Kentucky LLC
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• Knopp&Flynn Chiropractic Center PSC
• Jennifer Nicole Knox
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• Amanda Jo Kopp
• Yvonne Newport Korwatch
• Ashley Krages
• Tina L Kreutzer, O.D.

• All providers in Shepherdsville, KY
• Addiction Medicine (Family Medicine) Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.
• 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.