Individual provider Active NPI

David John Koenig, MD

  • Hospitalist Physician
  • Bolivia, NC
National Provider Identifier
1811975469
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2009-01147 Issued in NC
Practice address
240 Hospital Dr NE
Bolivia, NC 28422-8346
Phone
(910) 721-2070
Fax
(910) 721-2074
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 297471 IA
Internal Medicine Physician 207R00000X R8N75 MO
Hospitalist Physician 208M00000X 2009-01147 NC Primary

Addresses

Primary practice location

240 Hospital Dr NE
Bolivia, NC 28422-8346

Mailing address

240 Hospital Dr NE
Bolivia, NC 28422-8346
Phone (910) 721-2070

Other identifiers 2

IdentifierTypeStateIssuer
2107425MedicaidIA
110229063OtherIARR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dkoenig16764@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040907000546 IA Practitioner - Internal MedicinePractitioner - Emergency Medicine 9133195613 Reassigns benefits to 6 organizations
I20090731000144 NC Practitioner - HospitalistPractitioner - Internal Medicine 9133195613 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Sanford School of Medicine of University of South Dakota, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

240 Hospital Nedr
Bolivia, NC 28422-8346
Phone (910) 721-2070

Hospital & facility affiliations

  • Novant Health Brunswick Medical Center Hospital, Supply, NC, CCN 340158
  • Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
297471IAMDInternal Medicine Physician
R8N75MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital of Franciscan Sisters Inc Current Accepting new patients
St Anthony Regional Hospital and Nursing Home Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Mercy Hospital of Franciscan Sisters Inc CurrentSince Feb 22, 2014 Accepting new patients
Brunswick Community Hospital, LLC CurrentSince Jan 27, 2018 Accepting new patients
Novant Health Medical Group, LLC Internal Medicine CurrentSince Aug 1, 2009 Accepting new patients
Floyd Valley Healthcare CurrentSince Jan 1, 2026 Accepting new patients
St Anthony Regional Hospital and Nursing Home CurrentSince Aug 1, 2014 Accepting new patients
Mercy Hospital of Franciscan Sisters Inc CurrentSince Feb 22, 2014 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 1, 2009 Accepting new patients
St Anthony Regional Hospital and Nursing Home CurrentSince Aug 1, 2014 Accepting new patients

Locations

405 S Clark St
Ste 100
Carroll, IA 51401
Phone (712) 792-1500

311 S Clark St
Carroll, IA 51401
Phone (712) 792-3581

701 E 2nd St
Ida Grove, IA 51445
Phone (712) 364-3311

1000 W Lincoln Way
Jefferson, IA 50129
Phone (515) 386-2114

1301 W Main St
Lake City, IA 51449
Phone (712) 464-3171

714 Lincoln St NE
Le Mars, IA 51031
Phone (712) 546-3338

201 8th Ave SE
Oelwein, IA 50662
Phone (319) 283-4321

240 Hospital Dr NE
Bolivia, NC 28422
Phone (336) 399-7678

1901 Randolph Rd
Charlotte, NC 28207
Phone (704) 316-2000

100 Hospital Dr
Louisburg, NC 27549
Phone (252) 438-4143

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 12

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 2

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1811975469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 HOSPITAL DR NE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228346",
            "telephone_number": "910-721-2070",
            "fax_number": "910-721-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 HOSPITAL DR NE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228346",
            "telephone_number": "910-721-2070",
            "fax_number": "910-721-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "297471",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R8N75",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2009-01147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2107425",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110229063",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dkoenig16764@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "240 Hospital Dr NE",
            "city": "Bolivia",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284228346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bolivia, NC

Sources for this page

Verify at the official NPI Registry.