NPIMap

Individual provider Active NPI

Mark Koenig, M.D.

  • Interventional Cardiology Physician
  • Nashville, TN
National Provider Identifier
1770521502
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
32261 Issued in TN
Practice address
4230 Harding Rd
Suite 330
Nashville, TN 37205
Phone
(615) 259-4545
Fax
(615) 565-6789
NPI assigned
Jun 3, 2006
Last updated
Aug 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 32261 TN
Interventional Cardiology Physician 207RI0011X 32261 TN Primary

Addresses

Primary practice location

4230 Harding Rd
Suite 330
Nashville, TN 37205

Mailing address

300 20TH Ave N Ste 403
Nashville, TN 37203-5180
Phone (615) 284-7260

Other identifiers 3

IdentifierTypeStateIssuer
P01376525OtherTNRR MEDICARE
3330967MedicaidTN
6012068OtherTNBLUE CROSS-BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050706001005 TN Practitioner - Cardiovascular Disease (Cardiology) 4385680883 Reassigns benefits to 1 organization
I20080111000440 KY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4385680883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Eastern Virginia Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Thomas Medical PartnersGroup PAC ID 1557269354, 588 clinicians

Practice addresses (Care Compare)

1559 Sparta St
McMinnville, TN 37110-1316
Phone (931) 815-4000

1700 Medical Ctr Pkwy
Murfreesboro, TN 37129-2245
Phone (615) 396-4685

201 Park St
FL 3
Bowling Green, KY 42101-1742
Phone (615) 222-3078

300 20TH Ave N
Nashville, TN 37203-2131
Phone (615) 284-1400

4220 Harding Pike
Nashville, TN 37205-2005
Phone (615) 222-6977

4230 Harding Pike
Nashville, TN 37205-2018

647 Dunlop LN
Suite 116
Clarksville, TN 37040-5165
Phone (931) 648-0064

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting137
Leg revascularization (restoring blood flow)11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TP782KYMDInternal Medicine Physician
32261TNMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Williamson County Hospital District Past Accepting new patients
Saint Thomas Outpatient Cardiac Catheterization Center, LLC Cardiovascular Disease Past Accepting new patients
Saint Thomas West Hospital Past Accepting new patients
Heart Group PLLC Cardiovascular Disease Past Accepting new patients
Williamson Hospitalist Program Past Accepting new patients

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1770521502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 20TH AVE N STE 403",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372035180",
            "telephone_number": "615-284-7260",
            "fax_number": "615-284-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 HARDING RD",
            "address_2": "SUITE 330",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37205",
            "telephone_number": "615-259-4545",
            "fax_number": "615-565-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "32261",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TN",
            "license": "32261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01376525",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3330967",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-BLUE SHIELD",
            "identifier": "6012068",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.