Individual provider Active NPI

Katherine Joella Koonce, FNP-C

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1760012256
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP142040 Issued in TX
Practice address
3455 Locke Ave
Fort Worth, TX 76107-5745
Phone
(817) 336-1189
NPI assigned
Jan 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP142040 TX Primary

Addresses

Primary practice location

3455 Locke Ave
Fort Worth, TX 76107-5745

Mailing address

3908 Piedmont Rd
Fort Worth, TX 76116-7914
Phone (817) 908-2812

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kkoonce194753@Direct.TexasHealth.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200211001996 TX Practitioner - Nurse Practitioner 1254767239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

3455 Locke Ave
Suite 315
Fort Worth, TX 76107-5747
Phone (817) 336-1189

Hospital & facility affiliations

  • DFW Home Health Home health agency, Fort Worth, TX, CCN 457575
  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135
  • Medical City Weatherford Hospital, Weatherford, TX, CCN 450203
  • Texas Health Harris Methodist Hospital Southwest F Hospital, Fort Worth, TX, CCN 450779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP142040TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Mar 1, 2020 Accepting new patients
Texas Health Physicians Group CurrentSince Mar 1, 2020 Accepting new patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group Past Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

3455 Locke Ave
Ste 315
Fort Worth, TX 76107
Phone (817) 336-1189

801 W Cannon St
Ft Worth, TX 76104
Phone (817) 250-7195

Interoperability endpoints

  • Direct secure messaging: kkoonce194753@direct.texashealth.org

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1760012256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3908 PIEDMONT RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761167914",
            "telephone_number": "817-908-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 LOCKE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761075745",
            "telephone_number": "817-336-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONCE",
        "first_name": "KATHERINE",
        "middle_name": "JOELLA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkoonce194753@Direct.TexasHealth.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "801 W Cannon St",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761043147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.