Individual provider Active NPI

Joseph Aaron Koon II

  • Internal Medicine Physician
  • Benton, AR
National Provider Identifier
1922687649
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E-16850 Issued in AR
Practice address
819 W Carpenter St
Benton, AR 72015-3349
Phone
(501) 778-8264
Fax
(501) 778-7360
NPI assigned
Apr 8, 2021
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-16850 AR Primary

Addresses

Primary practice location

819 W Carpenter St
Benton, AR 72015-3349

Mailing address

14221 Parkside Dr
Little Rock, AR 72211-3036
Phone (501) 920-4624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240628003498 AR Practitioner - Internal Medicine 7810397833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

819 W Carpenter St
Benton Family Clinic
Benton, AR 72015-3349
Phone (501) 778-8264

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group CurrentSince Jun 13, 2024 Accepting new patients
Arkansas Health Group CurrentSince Jun 13, 2024 Accepting new patients
Arkansas Health Group Past Accepting new patients

Locations

819 W Carpenter St
Benton, AR 72015
Phone (501) 663-6262

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

Interoperability endpoints

  • Direct secure messaging: jkoon751932@direct.baptist-healthar.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1922687649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14221 PARKSIDE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113036",
            "telephone_number": "501-920-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 W CARPENTER ST",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153349",
            "telephone_number": "501-778-8264",
            "fax_number": "501-778-7360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOON",
        "first_name": "JOSEPH",
        "middle_name": "AARON",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-08",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-16850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

Verify at the official NPI Registry.