Brendan Paul Koning, APRN, CPNP

Individual provider Active NPI Pediatric Nurse Practitioner · New Market, MD

NPI 1740748649 · NPPES record last updated Jul 29, 2020

Key facts

NPI
1740748649
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
License
APRN11006116 (FL)
Practice address
11717 Old National Pike Ste 8
New Market, MD 21774-6119
Phone
(301) 882-7489
NPI assigned
Mar 10, 2019
Sex
Male
Sole proprietor
No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11006116FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
White Oak Pediatrics DRS Battiata & Impeduglia PA Past Accepting new patients
White Oak Pediatrics, DRS. Battiata & Impeduglia, P.a. Past Accepting new patients
White Oak Pediatrics DRS Battiata & Impeduglia PA Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: brendan.koning@wopmd.eclinicaldirectplus.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN11006116 FL Yes

Addresses

Primary practice location

11717 Old National Pike Ste 8
New Market, MD 21774-6119

Mailing address

11717 Old National Pike Ste 8
New Market, MD 21774-6119
Phone (301) 882-7489

Other providers in New Market, MD

All providers in New Market, MD · Pediatric Nurse Practitioner in Maryland

Sources for this page

Verify at the official NPI Registry.