Active NPI
Chad A Koenig
- Registered Dietitian
- Fort Bragg, NC
National Provider Identifier
1851482301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT05504
- Practice address
- BLDG. 4-2817 Box 281
Fort Bragg, NC 28310 - Phone
- (910) 907-6955
- NPI assigned
- Sep 28, 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT05504 | TX | Primary |
Addresses
Primary practice location
BLDG. 4-2817 Box 281
Fort Bragg, NC 28310
Mailing address
PO Box 72711
Fort Bragg, NC 28307-2711
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT05504 | TX | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851482301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 72711",
"city": "FORT BRAGG",
"state": "NC",
"postal_code": "283072711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BLDG. 4-2817 BOX 281",
"city": "FORT BRAGG",
"state": "NC",
"postal_code": "28310",
"telephone_number": "910-907-6955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOENIG",
"first_name": "CHAD",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT05504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Bragg, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.