Individual provider Active NPI

Thomas Alexander Koen, APRN,AGNP-C

  • Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1801353503
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1128686 Issued in AL
Practice address
1 Perimeter Park S Ste 195a
Birmingham, AL 35243-2327
Phone
(668) 490-6928
Fax
(888) 973-8821
NPI assigned
Feb 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11029288 FL
Nurse Practitioner 363L00000X 35665 TN
Nurse Practitioner 363L00000X 5020445 NC
Nurse Practitioner 363L00000X 28796 SC
Nurse Practitioner 363L00000X APRN.CNP.0037904 OH
Nurse Practitioner 363L00000X 1178922 TX
Nurse Practitioner 363L00000X 1128686 AL Primary

Addresses

Primary practice location

1 Perimeter Park S Ste 195a
Birmingham, AL 35243-2327

Mailing address

PO Box 211699
Eagan, MN 55121-3699
Phone (866) 849-0692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, FL, TN, SC, NC, TX6 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 6

Enrollment IDStateProvider typePAC IDDetails
I20190603003051 AL Practitioner - Nurse Practitioner 0042543274 Reassigns benefits to 2 organizations
I20240418000444 FL Practitioner - Nurse Practitioner 0042543274 Reassigns benefits to 1 organization
I20240423003085 TN Practitioner - Nurse Practitioner 0042543274 Reassigns benefits to 1 organization
I20240704000234 SC Practitioner - Nurse Practitioner 0042543274 Reassigns benefits to 1 organization
I20240913002733 NC Practitioner - Nurse Practitioner 0042543274 Reassigns benefits to 1 organization
I20250106002779 TX Practitioner - Nurse Practitioner 0042543274 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35665TNMDPharmacist
1128686ALMDNurse Practitioner
5020445NCMDNurse Practitioner
APRN11029288FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Devoted Medical Group Professional Corporation CurrentSince Apr 5, 2024 Accepting new patients
Devoted Medical NC PC CurrentSince Jul 22, 2024 Accepting new patients
Chilton Family Medicine, P.C. CurrentSince Apr 1, 2019 Accepting new patients
Devoted Medical Group of Texas Inc CurrentSince Dec 23, 2024 Accepting new patients
Price Medical Services LLC Current Accepting new patients

Locations

107 Health Center Dr
Clanton, AL 35045
Phone (205) 280-1010

880 SW 145th Ave
Ste 202
Pembroke Pines, FL 33027
Phone (615) 275-6612

221 Crescent St
Ste 202
Waltham, MA 02453
Phone (617) 958-1611

220 N Main St
Ste 500
Greenville, SC 29601
Phone (347) 294-3414

3200 West End Ave
Nashville, TN 37203
Phone (615) 510-1646

1201 Fannin St
Ste 262
Houston, TX 77002
Phone (714) 873-6202

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1801353503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211699",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551213699",
            "telephone_number": "866-849-0692",
            "fax_number": "888-973-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PERIMETER PARK S STE 195A",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352432327",
            "telephone_number": "668-490-6928",
            "fax_number": "888-973-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEN",
        "first_name": "THOMAS",
        "middle_name": "ALEXANDER",
        "credential": "APRN,AGNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-28",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11029288",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "35665",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5020445",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "28796",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0037904",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1178922",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1128686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.