Thomas J. Koontz, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

15108 Issued in NC

Practice address

2915 Lyndhurst Ave
Winston-Salem, NC 27103-4005

Phone

(336) 765-5221

Fax

(336) 765-0430

NPI assigned

Mar 22, 2006

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1700845211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 ALLISTAIR RD",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271041204",
            "telephone_number": "336-768-0196",
            "fax_number": "336-765-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 LYNDHURST AVE",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271034005",
            "telephone_number": "336-765-5221",
            "fax_number": "336-765-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONTZ",
        "first_name": "THOMAS",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "15108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8950063",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC LICENSE",
            "identifier": "15108",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frederick Alan Koontz, M.D.
• Jessica Brooke Koontz, MD
• Kellie Preslar Koontz, NP
• Kenneth Louis Koontz
• Morgan Koontz, PA-C
• Gwyn E Kooy, M.D.
• Bryan Matthew Koppa, MD
• Maleah Koppa, LCSW
• Ivana Korankyi, PHARMACIST
• Aryn Elizabeth Kormanis, DO

• Surgery Physician in Winston-Salem, NC
• Providers in Winston-Salem, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.