Impact Infusion Care, LLC.

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

Legal business name

IMPACT INFUSION CARE, LLC.

Practice address

9000 Tesoro Dr Ste 600
San Antonio, TX 78217-6130

Phone

(210) 646-4888

Fax

(726) 800-4974

NPI assigned

Jun 23, 2023

Organization subpart

No

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

Authorized official

Name

Dustin William Koenning, R.PH, PHARM.D.NPI 1154852150

Title

Pharmacist in Charge

Phone

(806) 577-3370

Specialties & licenses 6

Addresses

Other names 1

• Impact Infusion Care Other name

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Home infusion therapy

Medicare-enrolled home infusion therapy supplier

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Impact Infusion Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Impact Infusion Care, LLC.

  • Home Infusion Therapy Pharmacy
  • Plano, TX
  • NPI 1457293656
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Impact Infusion Care, LLC.

  • Home Infusion Therapy Pharmacy
  • Plano, TX
  • NPI 1457293656
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dustin William Koenning, R.PH., PHARM. D

  • Pharmacist
  • San Antonio, TX
  • NPI 1154852150
  NPD Authorized official

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1821774910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 TESORO DR STE 600",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782176130",
            "telephone_number": "210-646-4888",
            "fax_number": "726-800-4974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 TESORO DR STE 600",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782176130",
            "telephone_number": "210-646-4888",
            "fax_number": "726-800-4974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT INFUSION CARE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "KOENNING",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "806-577-3370",
        "authorized_official_credential": "R.PH, PHARM.D."
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Impact Infusion Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Home Infusion Therapy Pharmacy in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Home Infusion Therapy Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.