Pittsburg Family Medicine LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

23565 Issued in KS

Legal business name

PITTSBURG FAMILY MEDICINE LLC

Practice address

2401 South Tucker Ave
Ste 2
Pittsburgh, KS 66762

Phone

(620) 235-1043

Fax

(620) 231-6555

NPI assigned

Aug 28, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daniel J Koehn, MDNPI 1164528220

Title

Physician

Phone

(620) 235-1043

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel Joseph Koehn, M.D.

  • Family Medicine Physician
  • Pittsburg, KS
  • NPI 1164528220
  Medicare reassignment Authorized official
• Kent J Cooper, M.D.

  • Family Medicine Physician
  • Pittsburg, KS
  • NPI 1215020763
  NPD (past)

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740398924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 SOUTH TUCKER AVE",
            "address_2": "STE 2",
            "city": "PITTSBURGH",
            "state": "KS",
            "postal_code": "66762",
            "telephone_number": "620-235-1043",
            "fax_number": "620-231-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 SOUTH TUCKER AVE",
            "address_2": "STE 2",
            "city": "PITTSBURGH",
            "state": "KS",
            "postal_code": "66762",
            "telephone_number": "620-235-1043",
            "fax_number": "620-231-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PITTSBURG FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOEHN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "620-235-1043",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "23565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jefferson Wayne Barkley, OD
• Michael W. Cannon, MD
• Donald Eugene Dangerfield Jr., ATC

• Family Medicine Physician in Pittsburgh, KS
• Providers in Pittsburgh, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.