Active NPI
Henry B Koon Jr., MD
- Hematology & Oncology Physician
- Cleveland, OH
National Provider Identifier
1811929334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- 154133
- Practice address
- 11100 Euclid Avenue
Cleveland, OH 44106 - Phone
- (216) 844-3951
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | 154133 | MA | Primary |
Addresses
Primary practice location
11100 Euclid Avenue
Cleveland, OH 44106
Mailing address
3605 Warrensville Center Rd
1St Floor
Shaker HTS, OH 44122
Phone (216) 286-6295
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000221364 | Other | OH | UNISUN |
| 000000527718 | Other | OH | ANTHEM |
| 2762587 | Medicaid | OH | |
| 414994 | Other | OH | WELLCARE |
| 750817 | Other | OH | BUCKEYE |
| 7538343 | Other | OH | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232668800000",
"number": "1811929334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3605 WARRENSVILLE CENTER RD",
"address_2": "1ST FLOOR",
"city": "SHAKER HTS",
"state": "OH",
"postal_code": "44122",
"telephone_number": "216-286-6295",
"fax_number": "216-286-6341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11100 EUCLID AVENUE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "44106",
"telephone_number": "216-844-3951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOON",
"first_name": "HENRY",
"middle_name": "B",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2009-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "MA",
"license": "154133",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISUN",
"identifier": "000000221364",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000527718",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2762587",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "414994",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BUCKEYE",
"identifier": "750817",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7538343",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.