Jahoon Koo, ACNPC-AG
Individual provider Active NPI Acute Care Nurse Practitioner · Stanley, WI
NPI 1629554209 · NPPES record last updated Dec 20, 2022
Key facts
- NPI
- 1629554209
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- APNP8026-33 (WI)
- Practice address
- 1120 Pine St
Stanley, WI 54768-1297 - Phone
- (800) 643-0554
- NPI assigned
- Jul 17, 2018
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 17
Hospital & facility affiliations 11
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aspirus Stanley Hospital and Clinics Inc
Aspirus Medford Hospital and Clinics Inc
Aspirus Stevens Point Hospital and Clinics, Inc.
Practice addresses (Care Compare)
1120 Pine St
Stanley, WI 54768-1297
Phone (715) 644-5530
135 S Gibson St
Medford, WI 54451-1622
Phone (715) 748-8100
900 Illinois Ave
Stevens Point, WI 54481-3114
Phone (715) 346-5000
Hospital & facility affiliations
- Aspirus Stanley Hospital
- Aspirus Medford Hospital & Clinics, Inc
- Aspirus Stanley Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201028000989 | WI | Practitioner - Nurse Practitioner | 1355692922 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APNP8026-33 | WI | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspirus Medford Hospital & Clinics, Inc. | Current |
Accepting new patients | |
| Aspirus Stanley Hospital & Clinics, Inc. | Current |
Accepting new patients | |
| Aspirus Stevens Point Hospital & Clinics, Inc. | Current |
Accepting new patients | |
| Aspirus Stanley Hospital & Clinics, Inc. | Current | Accepting new patients | |
| Aspirus Stanley Hospital & Clinics, Inc | Current | Accepting new patients | |
| Aspirus Stanley Hospital & Clinics, Inc. | Current |
Accepting new patients | |
| Aspirus Medford Hospital & Clinics, Inc. | Current |
Accepting new patients | |
| Aspirus Medford Hospital & Clinics, Inc. | Current | Accepting new patients | |
| Aspirus Stevens Point Hospital & Clinics, Inc. | Current |
Accepting new patients | |
| Aspirus Stanley Hospital & Clinics, Inc | Current |
Accepting new patients | |
| Aspirus Medford Hospital & Clinics, Inc. | Current | Accepting new patients |
Locations
29980 Network Pl
Chicago, IL 60673
143 S Gibson St
Medford, WI 54451
Phone (715) 748-2121
135 S Gibson St
Medford, WI 54451
Phone (715) 748-8100
6 Johnson St
Owen, WI 54460
Phone (715) 229-2177
1120 Pine St
Stanley, WI 54768
Phone (715) 644-5530
209 Prentice St N
Stevens Point, WI 54481
Phone (715) 344-4611
900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500
704 S Clark St
Thorp, WI 54771
Phone (715) 669-5536
190 Grand Seasons Dr
Waupaca, WI 54981
Phone (715) 258-3401
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | APNP8026-33 | WI | Yes |
Addresses
Primary practice location
1120 Pine St
Stanley, WI 54768-1297
Mailing address
12111 W Beloit Rd Apt 6
Greenfield, WI 53228-1910
Phone (262) 709-6597
Other providers in Stanley, WI
- Wayne Alan Hove
- Katherine Jackson-Schneider
- Steven F Jacobs
- Daniel Johnson
- Alex A Kobylarczyk
- Victoria Kramar
- Joleen Lamarche
- Mary Larue
- Benjamin Roger Lawrence
- Betsy Luxford
All providers in Stanley, WI · Acute Care Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.