NPIMap

Individual provider Active NPI

Rita Carol Koon, FNP BC

  • Family Nurse Practitioner
  • Union City, TN
National Provider Identifier
1649500083
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN0000014862 Issued in TN
Practice address
702 Sherrill St Ste B
Union City, TN 38261-5891
Phone
(731) 885-8884
NPI assigned
Jan 7, 2010
Last updated
Jul 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN0000014862 TN Primary
Registered Nurse 163W00000X RN0000106605 TN

Addresses

Primary practice location

702 Sherrill St Ste B
Union City, TN 38261-5891

Mailing address

702 Sherrill St Ste B
Union City, TN 38261-5891
Phone (731) 885-8884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100917000675 TN Practitioner - Nurse Practitioner 1658496310 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Primary Care, PLLCGroup PAC ID 3870816721, 6 clinicians

Practice addresses (Care Compare)

702 Sherrill St
Suite B
Union City, TN 38261-5891
Phone (731) 885-8884

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN0000106605TNMDRegistered Nurse
APN0000014862TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Jul 5, 2016 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Jul 5, 2016 Accepting new patients
Premier Primary Care, PLLC CurrentSince Feb 18, 2019 Accepting new patients
Premier Primary Care, PLLC Family CurrentSince Feb 18, 2019 Accepting new patients
Allcare Medical Troy, PLLC PastSince May 11, 2013 Accepting new patients
Thrive Family Healthcare, PLLC PastSince May 4, 2025 Accepting new patients
Premier Primary Care PLLC Family Past Accepting new patients

Locations

702 Sherrill St
#B
Union City, TN 38261
Phone (731) 885-8884

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CIAIDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/JCCDCD
  • Direct secure messaging: rita.koon@ppcuct.eclinicaldirectplus.com

Organizations & group practices 7

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 4

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": "1262822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1649500083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SHERRILL ST STE B",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615891",
            "telephone_number": "731-885-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 SHERRILL ST STE B",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615891",
            "telephone_number": "731-885-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOON",
        "first_name": "RITA",
        "middle_name": "CAROL",
        "credential": "FNP BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-07",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000014862",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN0000106605",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, TN

Sources for this page

Verify at the official NPI Registry.