Active NPI
Robert Koe, M.D.
- Internal Medicine Physician
- Orange Park, FL
National Provider Identifier
1609091081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME0039855
- Practice address
- 1543 Kingsley Avenue
Building #12
Orange Park, FL 32073 - Phone
- (904) 269-9777
- Fax
- (904) 264-9774
- NPI assigned
- Apr 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0039855 | FL | |
| Internal Medicine Physician | 207R00000X | ME0039855 | FL | Primary |
Addresses
Primary practice location
1543 Kingsley Avenue
Building #12
Orange Park, FL 32073
Mailing address
PO Box 2250
Orange Park, FL 32067-2250
Phone (904) 269-9777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 066967900 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0039855 | FL | MD | Internal Medicine Physician |
| ME0039855 | FL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Antoinette N. Koe M.D, P.a | Internal Medicine | 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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Orange Park, FL
- NPI 1235418286
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308182400000",
"number": "1609091081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2250",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320672250",
"telephone_number": "904-269-9777",
"fax_number": "904-264-9774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1543 KINGSLEY AVENUE",
"address_2": "BUILDING #12",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "32073",
"telephone_number": "904-269-9777",
"fax_number": "904-264-9774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOE",
"first_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-13",
"last_updated": "2011-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "0039855",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME0039855",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "066967900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Orange Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.