Thomas A Koenig, SAC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

02-296 Issued in KY

Practice address

560 South Loop Rd
Edgewood, KY 41017-3454

Phone

(859) 301-2663

Fax

(859) 301-0655

NPI assigned

Jun 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Thomas A Koenig Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1689678914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 SOUTH LOOP RD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173454",
            "telephone_number": "859-301-2663",
            "fax_number": "859-301-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 SOUTH LOOP RD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173454",
            "telephone_number": "859-301-2663",
            "fax_number": "859-301-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "THOMAS",
        "middle_name": "A",
        "credential": "SAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "02-296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHOICE CARE PROVIDER ID",
            "identifier": "CSA98601",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THOMAS",
            "last_name": "KOENIG",
            "middle_name": "A",
            "credential": "OPA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jamie Kmety, MD
• Zoey Theresa-Jean Knox, MD
• Jennifer Knuckles
• Andrew William Koch, PT
• Debra R Koenig, CRNA
• Dhanashri D Kohok, M.D.
• Jessica Kong, RBT
• Courtney Koogler, PHARMD
• Christina M Kopras, MSN, RN, CNL FNP
• Aryn Korell, RBT

• Surgical Physician Assistant in Edgewood, KY
• Providers in Edgewood, KY by specialty
• Surgical Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.