Active NPI
Kristen Jo Koon, PHARMD
- Pharmacist
- Tupelo, MS
National Provider Identifier
1871098475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E12979
- Practice address
- 817 W Main St
Tupelo, MS 38801-3630 - Phone
- (662) 620-7959
- NPI assigned
- Mar 26, 2018
- Last updated
- Mar 26, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | E12979 | MS | Primary |
Addresses
Primary practice location
817 W Main St
Tupelo, MS 38801-3630
Mailing address
2402 Country Club Rd
Tupelo, MS 38804-1106
Phone (662) 255-9131
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E12979 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522022400000",
"number": "1871098475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2402 COUNTRY CLUB RD",
"city": "TUPELO",
"state": "MS",
"postal_code": "388041106",
"telephone_number": "662-255-9131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "817 W MAIN ST",
"city": "TUPELO",
"state": "MS",
"postal_code": "388013630",
"telephone_number": "662-620-7959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOON",
"first_name": "KRISTEN",
"middle_name": "JO",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-26",
"last_updated": "2018-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E12979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.