Amber Rachael Koonce, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1075 Grandview Ave Ste 200
Grants Pass, OR 97527-5118

Phone

(541) 476-2841

NPI assigned

May 24, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, TX2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health AllianceGroup PAC ID 6305731068, 119 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Providence Hospital, Waco, TX, CCN 450042

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amber.koonce.1@9635.direct.athenahealth.com

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.

• Providence Health Alliance

  • Specialist
  • Waco, TX
  • NPI 1932210838
  Medicare reassignment Care Compare group
• Women'S Health Center of Southern Oregon PC

  • Obstetrics & Gynecology Physician
  • Grants Pass, OR
  • NPI 1528175437
  Medicare reassignment
• Providence Health Alliance

  • Rural Health Clinic/Center
  • Waco, TX
  • NPI 1336590462
  NPD

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

• Ascension Providence

  • General Acute Care Hospital
  • Waco, TX
  • NPI 1093708679
  Care Compare affiliation

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506643200000",
    "number": "1760839328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 GRANDVIEW AVE STE 200",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 GRANDVIEW AVE STE 200",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275118",
            "telephone_number": "541-476-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONCE",
        "first_name": "AMBER",
        "middle_name": "RACHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-24",
        "last_updated": "2017-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Koepke
• William Lee Kohn, M.D.
• Alexandrea M Kolberg
• Paloma Sita Kolkow
• Heidi Konopa, OT/L
• Rachel Kostrna
• Andrew Kozerski
• Meumbur Praise Kpughur-Tule, MD
• Patricia Arleen Kraemer, PSS
• Curtis Dean Kramer, CHW/CNA

• Physician Assistant in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.