Individual provider Active NPI

Christina Marie Koonce, M.D.

  • Family Medicine Physician
  • Lansing, MI
National Provider Identifier
1952470361
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
00004301093690 Issued in MI
Practice address
1717 N High St
Lansing, MI 48906-4597
Phone
(517) 253-8243
Fax
(517) 371-4245
NPI assigned
Nov 7, 2006
Last updated
May 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 00004301093690 MI Primary

Addresses

Primary practice location

1717 N High St
Lansing, MI 48906-4597

Mailing address

1717 N High St
Lansing, MI 48906-4597
Phone (517) 253-8243

Other identifiers 1

IdentifierTypeStateIssuer
8293672MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20220720003230 MI Practitioner - Family Practice 1850372830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cristo Rey Community CenterGroup PAC ID 2365345576, 5 clinicians

Practice addresses (Care Compare)

1717 N High St
Lansing, MI 48906-4529
Phone (517) 371-1700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00004301093690MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities of Ingham, Eaton & Clinton Counties CurrentSince Apr 15, 2022 Accepting new patients
Desmoines Valley BHS Past Accepting new patients
Our Lady of Lourdes Health Center Past Accepting new patients
Cristo Rey Community Center PastSince Jun 4, 2023 Accepting new patients

Locations

1717 N High St
Lansing, MI 48906
Phone (517) 371-1700

Interoperability endpoints

  • Direct secure messaging: ckoonce91191@sparrowdirecthie.org

Organizations & group practices 4

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 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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1952470361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 N HIGH ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489064597",
            "telephone_number": "517-253-8243",
            "fax_number": "517-371-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 N HIGH ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489064597",
            "telephone_number": "517-253-8243",
            "fax_number": "517-371-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONCE",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "00004301093690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8293672",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.