Individual provider Active NPI

David B Koontz, CRNA

  • Certified Registered Nurse Anesthetist
  • Tampa, FL
National Provider Identifier
1487713897
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9244008 Issued in FL
Practice address
2 Columbia Dr
Suite A327
Tampa, FL 33606-3508
Phone
(813) 844-4396
Fax
(813) 844-4972
NPI assigned
Dec 8, 2006
Last updated
Jun 17, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 9244008 FL Primary

Addresses

Primary practice location

2 Columbia Dr
Suite A327
Tampa, FL 33606-3508

Mailing address

2 Columbia Dr
Suite A327
Tampa, FL 33606-3508
Phone (813) 844-4396

Other identifiers 3

IdentifierTypeStateIssuer
308193100MedicaidFL
G4161OtherFLBCBS
P00391888OtherFLMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070423000294 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355446261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 844-4396

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
9244008FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Nov 1, 2006 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Nov 1, 2006 Accepting new patients
Michigan Gulf to Bay Anesthesiology Associates PSC Past Accepting new patients

Locations

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

2 Columbia Dr
Ste A327
Tampa, FL 33606
Phone (813) 844-4116

400 N Ashley Dr
Ste 1625
Tampa, FL 33602
Phone (813) 289-6597

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-0793

Interoperability endpoints

  • Direct secure messaging: dkoontz9097@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1487713897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 COLUMBIA DR",
            "address_2": "SUITE A327",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063508",
            "telephone_number": "813-844-4396",
            "fax_number": "813-844-4972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COLUMBIA DR",
            "address_2": "SUITE A327",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063508",
            "telephone_number": "813-844-4396",
            "fax_number": "813-844-4972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONTZ",
        "first_name": "DAVID",
        "middle_name": "B",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9244008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308193100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "G4161",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00391888",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.