Rita Carol Koon, FNP BC
Individual provider Active NPI Family Nurse Practitioner · Union City, TN
NPI 1649500083 · NPPES record last updated Jul 30, 2020
Key facts
- NPI
- 1649500083
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APN0000014862 (TN)
- Practice address
- 702 Sherrill St Ste B
Union City, TN 38261-5891 - Phone
- (731) 885-8884
- NPI assigned
- Jan 7, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Premier Primary Care, PLLC
Practice addresses (Care Compare)
702 Sherrill St
Suite B
Union City, TN 38261-5891
Phone (731) 885-8884
Hospital & facility affiliations
- Volunteer Home Care
- Amedisys Home Health Care
- Baptist Memorial Hospital Union City
- Volunteer Community Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- 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 |
|---|---|---|---|---|
| I20100917000675 | TN | Practitioner - Nurse Practitioner | 1658496310 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN0000106605 | TN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Primary Care, PLLC | Current |
Accepting new patients | |
| Premier Primary Care, PLLC | Family | Current |
Accepting new patients |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Allcare Medical Troy, PLLC | Past |
Accepting new patients | |
| Thrive Family Healthcare, PLLC | Past |
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
- https://fhir4.healow.com/fhir/r4/CIAIDD
- https://fhir4.healow.com/fhir/r4/JCCDCD
- rita.koon@ppcuct.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APN0000014862 | TN | Yes |
| 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
Other providers in Union City, TN
- Kizer Pharmacy LLC
- Kizer Pharmacy LLC
- Jason Smith Kizer
- Tracey Kizer
- Kofi Nuako, MD, PC
- La Speech Therapy PC
- Madison Sturgeon Lamar
- Elliott Landfield
- Christopher Allen Lane
- Rainelda Lariosa
All providers in Union City, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2020. 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.