Individual provider Active NPI

Sydney Koenig

  • Family Medicine Physician
  • Swainsboro, GA
National Provider Identifier
1639756364
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
101835 Issued in GA
Practice address
401 W Main St
Swainsboro, GA 30401-3110
Phone
(478) 237-9928
Fax
(478) 763-3787
NPI assigned
Mar 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 101835 GA Primary

Addresses

Primary practice location

401 W Main St
Swainsboro, GA 30401-3110

Mailing address

1123 Paris Ave
Swainsboro, GA 30401-6062
Phone (912) 414-2033

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20241120003820 GA Practitioner - Family Practice 6305371808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Mercer University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

120 A Victory Dr
Swainsboro, GA 30401-3235
Phone (478) 237-3291

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Vidalia, GA, CCN 117075
  • University Home Health Services Home health agency, Waynesboro, GA, CCN 117068
  • Emanuel Medical Center Hospital, Swainsboro, GA, CCN 110109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
101835GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emanuel County Hospital Authority CurrentSince Sep 16, 2024 Accepting new patients
Emanuel County Hospital Authority Current Accepting new patients
Emanuel County Hospital Authority Past Accepting new patients

Locations

305 Kite Rd
Swainsboro, GA 30401
Phone (478) 237-2144

131A Victory Dr
Swainsboro, GA 30401
Phone (478) 237-8342

117 Kite Rd
Swainsboro, GA 30401
Phone (248) 972-8725

131 Victory Dr
#C
Swainsboro, GA 30401

401 W Main St
Swainsboro, GA 30401
Phone (478) 237-9928

115 Gillikin St
Twin City, GA 30471
Phone (478) 763-2760

Interoperability endpoints

  • Direct secure messaging: sydney.koenig@emcsim.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1616803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1639756364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 PARIS AVE",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304016062",
            "telephone_number": "912-414-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W MAIN ST",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304013110",
            "telephone_number": "478-237-9928",
            "fax_number": "478-763-3787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "SYDNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-27",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "101835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swainsboro, GA

Sources for this page

Verify at the official NPI Registry.