MIKAELA JEAN KOENIG (NPI# 1609253806) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609253806 |
| Entity Type | Individual |
| Full Name | MIKAELA JEAN KOENIG |
| Other Name | MIKAELA JEAN MILLER |
| Practice Address |
513 3rd St Sw Wagner SD 57380-9675 |
| Mailing Address |
37184 302nd St Fairfax SD 57335-5335 |
| Practice Telephone | 6053843418 |
| Practice Fax Number | 6053845240 |
| Mailing Telephone | 4023406372 |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2019-03-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 11242 | SD | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1115 East 20th Street, Sioux Falls, SD 57105 | 6053391783 |
| Street Address |
513 3RD ST SW |
| City | WAGNER |
| State | SD |
| Zip Code | 57380-9675 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326030974 | Wagner Community Memorial Hospital | General Acute Care Hospital | 513 3rd St Sw, Wagner, SD 57380-9675 | 2005-08-19 |
| 1457950321 | Jared Van Winkle | Physical Therapist | 513 3rd St Sw, Wagner, SD 57380-9675 | 2020-10-21 |
| 1487263513 | Cassie Lynn Nelson | Nurse Practitioner | 513 3rd St Sw, Wagner, SD 57380-9675 | 2020-07-24 |
| 1356824148 | Ryan Kocer | Nurse Practitioner | 513 3rd St Sw, Wagner, SD 57380-9675 | 2018-09-08 |
| 1285143891 | Jessica M Vanderham | Nurse Practitioner | 513 3rd St Sw, Wagner, SD 57380-9675 | 2017-09-26 |
| 1013377944 | Lindsey Nedved | Nurse Practitioner | 513 3rd St Sw, Wagner, SD 57380-9675 | 2016-03-04 |
| 1427322957 | Jordan Carl Weber | Physician Assistant | 513 3rd St Sw, Wagner, SD 57380-9675 | 2012-03-01 |
| 1285964494 | Wagner Community Memorial Hospital Avera | Clinical Medical Laboratory | 513 3rd St Sw, Wagner, SD 57380-9675 | 2010-01-11 |
| 1003079419 | Uzma Amer Mian | Internal Medicine | 513 3rd St Sw, Wagner, SD 57380-9675 | 2008-07-07 |
| 1740306992 | Wagner Community Memorial Hospital | Nurse Practitioner | 513 3rd St Sw, Wagner, SD 57380-9675 | 2007-03-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083070593 | Carol Lee Stewart | Nurse Practitioner | 513 3rd Street Sw, Wagner, SD 57380 | 2016-01-13 |
| 1174906705 | Jerika Kirwan | Optometrist | 720 West Hwy 46, Wagner, SD 57380 | 2015-07-01 |
| 1134334766 | Drew Tyler Anderson | Chiropractor | 109 1st St Sw, Wagner, SD 57380 | 2007-05-14 |
| 1326066796 | Wagner Indian Health Service Health Center | Clinic/Center | 111 Washington Ave, Wagner, SD 57380 | 2006-07-17 |
| 1447220603 | Jay Joseph Fitzgerald | Chiropractor | 109 1st. St. Sw, Wagner, SD 57380 | 2006-01-23 |
| 1649759499 | The Evangelical Lutheran Good Samaritan Society | Nurse Practitioner | 515 W Highway 46, Wagner, SD 57380 | 2018-08-13 |
| 1972754422 | Timothy Eric Sass | Pharmacist | 111 Washington Ave Nw, Wagner, SD 57380 | 2008-10-02 |
| 1275741878 | Patricia Ann Goulette | Registered Nurse | 111 Washington Ave Nw, Wagner, SD 57380 | 2007-05-18 |
| 1073721510 | Barbara Slaba | Registered Nurse | 111 Washington Ave Nw, Wagner, SD 57380 | 2007-05-18 |
| 1225246770 | Martha J Geuther | Registered Nurse | 111 Washington Ave Nw, Wagner, SD 57380 | 2007-05-18 |
| Find all providers in zip 57380 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487616827 | Gretchen Marie Esplund | Family Medicine | 111 Washington Avenue North West, Wagner, SD 57380-0490 | 2006-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396343505 | Kaitlyn Mae Fritz | Family Medicine | Wellness Center 103, Brookings, SD 57007-0001 | 2020-10-12 |
| 1447877386 | Black Hills Primary Care PC | Family Medicine | 8075 Stage Stop Rd., Summerset, SD 57718 | 2020-06-26 |
| 1467003251 | Arthur Lampert | Family Medicine | 1770 Tablerock Rd Apt 120, Rapid City, SD 57701-5586 | 2019-09-24 |
| 1851883540 | Modern Day Health Care Prof LLC | Family Medicine | 125 Railroad Ave Se, Aberdeen, SD 57401-4202 | 2018-05-30 |
| 1427555002 | Sanford Clinic | Family Medicine | 136 S Phillips Ave Ste 102, Sioux Falls, SD 57104 | 2018-04-10 |
| 1023524741 | Quick Health Urgent Care LLC | Family Medicine | 7600 S Louise Ave Ste 150, Sioux Falls, SD 57108-5999 | 2017-12-18 |
| 1568991446 | Callie Pederson | Family Medicine | 28th Medical Group, 2900 Doolitle Drive, Ellsworth Afb, SD 57706-4821 | 2017-06-05 |
| 1144751256 | Maya Itza Koehler | Family Medicine | 534 Oregon Ave Se, Huron, SD 57350-2801 | 2017-03-22 |
| 1578004883 | Sacred Heart Health Services | Family Medicine | 2525 Fox Run Pkwy Ste 200, Yankton, SD 57078-5371 | 2017-03-20 |
| 1073992004 | Monument Health Network, Inc. | Family Medicine | 209 Ramsland St, Buffalo, SD 57720-0045 | 2015-05-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.