Individual provider Active NPI

Laura Koenig, M.D.

  • Internal Medicine Physician
  • Fort Atkinson, WI
National Provider Identifier
1700881869
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
38038 Issued in WI
Practice address
500 McMillen St
Fort Atkinson, WI 53538-1233
Phone
(920) 563-5571
Fax
(920) 563-7705
NPI assigned
Jun 16, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 38038 WI Primary

Addresses

Primary practice location

500 McMillen St
Fort Atkinson, WI 53538-1233

Mailing address

500 McMillen St
Fort Atkinson, WI 53538-1233
Phone (920) 563-5571

Other identifiers 1

IdentifierTypeStateIssuer
32420500MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20070720000846 WI Practitioner - Internal Medicine 6901907963 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Healthcare Inc CurrentSince Aug 1, 2007 Accepting new patients
Fort Healthcare Inc Current Accepting new patients

Locations

704 Katie Ct
Cambridge, WI 53523
Phone (608) 423-1100

500 McMillen St
Fort Atkinson, WI 53538
Phone (920) 563-5571

512 Wilcox St
Fort Atkinson, WI 53538
Phone (920) 563-7366

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

1461 W Main St
Whitewater, WI 53190
Phone (262) 472-6839

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/8F7ruIta-JA7ecm4ommy-Q50dF1FkFe4/
  • Direct secure messaging: laura.koenig@direct.forthc.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1700881869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MCMILLEN ST",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381233",
            "telephone_number": "920-563-5571",
            "fax_number": "920-563-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MCMILLEN ST",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381233",
            "telephone_number": "920-563-5571",
            "fax_number": "920-563-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "LAURA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "38038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32420500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Atkinson, WI

Sources for this page

Verify at the official NPI Registry.