Active NPI
Patricia Claire Koonce, MD
- Pediatrics Physician
- Columbia, MO
National Provider Identifier
1982890455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- R1D69
- Practice address
- 315 Business Loop 70 W
Columbia, MO 65203-3248 - Phone
- (573) 884-0033
- Fax
- (573) 884-5226
- NPI assigned
- Sep 19, 2007
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | R1D69 | MO | Primary |
Addresses
Primary practice location
315 Business Loop 70 W
Columbia, MO 65203-3248
Mailing address
PO Box 7687
Columbia, MO 65205-7687
Phone (573) 882-8612
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 206971319 | Medicaid | MO |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307318400000",
"number": "1982890455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7687",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652057687",
"telephone_number": "573-882-8612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 BUSINESS LOOP 70 W",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652033248",
"telephone_number": "573-884-0033",
"fax_number": "573-884-5226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOONCE",
"first_name": "PATRICIA",
"middle_name": "CLAIRE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-19",
"last_updated": "2011-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "R1D69",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "206971319",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.