DR. JUSTIN JACOB KOENIG (NPI# 1821314360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1821314360 |
Entity Type | Individual |
Full Name | DR. JUSTIN JACOB KOENIG |
Credential | D.O. |
Practice Address |
621 Memorial Dr Ste 502 South Bend IN 46601 |
Mailing Address |
710 N Niles Ave South Bend IN 46617-1924 |
Practice Telephone | 5746475875 |
Practice Fax Number | 5746475878 |
Mailing Telephone | 5746471610 |
Mailing Fax Number | 5742376069 |
Enumeration Date | 2010-04-08 |
Last Update Date | 2019-07-17 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208600000X | Surgery | 02005590A | IN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 300024549 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
4102 Pinion Dr, United States Air Force Acad, CO 808402502 | 7193335140 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689100927 | Justin Koenig | Physical Therapist | 1000 Broadway, Suite 500, Oakland, CA 94607-4099 | 2017-05-05 |
Street Address |
621 MEMORIAL DR STE 502 |
City | SOUTH BEND |
State | IN |
Zip Code | 46601 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538136361 | Mark A Thompson | Surgery | 621 Memorial Dr Ste 502, South Bend, IN 46601-1075 | 2006-03-01 |
1942835582 | Virginia Clare Wrigley | Nurse Practitioner | 621 Memorial Dr Ste 502, South Bend, IN 46601-1075 | 2020-03-04 |
1447721105 | Daniela M Edson | Nurse Practitioner | 621 Memorial Dr Ste 502, South Bend, IN 46601-1075 | 2018-12-06 |
1548777295 | Lourine Garcia | Nurse Practitioner | 621 Memorial Dr Ste 502, South Bend, IN 46601-1075 | 2018-01-03 |
1174927131 | Beacon Medical Group, Inc. | Surgery | 621 Memorial Dr Ste 502, South Bend, IN 46601-1075 | 2014-10-20 |
1326459108 | Katherine Delayne Goze | Surgery | 621 Memorial Dr Ste 502, South Bend, IN 46601-1075 | 2014-05-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447610449 | David Thomas | Hearing Instrument Specialist | 808 S Michigan St., South Bend, IN 46601 | 2016-03-03 |
1285072454 | Kevin Francis Cumper | Internal Medicine | 621 Memorial Dr Ste 624, South Bend, IN 46601 | 2013-06-11 |
1952605560 | Robert Lusk Bonham | Dentist | 1222 L.w.e., So. Bend, IN 46601 | 2010-12-23 |
1649580911 | Daniel Scott Debrule | Psychologist | 211 W. Washington Street, Suite 2311, South Bend, IN 46601 | 2010-10-20 |
1528390770 | Luke Alfred White | Internal Medicine | 615 N. Michigan St., Memorial Hospital, C/o Erin Smith, South Bend, IN 46601 | 2010-02-12 |
1548497837 | Tmg Home Health Care | Home Health | 108 N Main St #305, South Bend, IN 46601 | 2009-06-15 |
1225283039 | Jody L. Hughes | Counselor | 202 S. Michigan Street, Suite 875, South Bend, IN 46601 | 2008-11-20 |
1740432574 | Amanda Jayne Quicksall | Social Worker | 611 Lincolnway W, South Bend, IN 46601 | 2008-10-10 |
1952565772 | Thomas P Judd | Dentist | 1901 #b Western Avenue, Ihc South Bend, South Bend, IN 46601 | 2008-07-10 |
1851590269 | Warren Larry Penrod | Nurse Practitioner | 333 W. Western Ave, South Bend, IN 46601 | 2007-07-16 |
Find all providers in zip 46601 |
Taxonomy Code | 208600000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538136361 | Mark A Thompson | Surgery | 621 Memorial Dr Ste 502, South Bend, IN 46601-1075 | 2006-03-01 |
1174927131 | Beacon Medical Group, Inc. | Surgery | 621 Memorial Dr Ste 502, South Bend, IN 46601-1075 | 2014-10-20 |
1326459108 | Katherine Delayne Goze | Surgery | 621 Memorial Dr Ste 502, South Bend, IN 46601-1075 | 2014-05-14 |
1508191768 | Allied Physicians of Michiana, LLC | Surgery | 621 Memorial Dr, Suite 302, South Bend, IN 46601-1063 | 2009-10-06 |
1013907781 | Robert G. Credi | Surgery | 211 N Eddy St, South Bend, IN 46617-2808 | 2005-10-25 |
1679562383 | Alfredo V Casetti | Surgery | 211 N Eddy St, South Bend, IN 46617-2808 | 2005-10-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902416076 | Elkhart Clinic, LLC | Surgery | 2240 Karisa Dr Ste 1, Goshen, IN 46526-6943 | 2020-08-04 |
1053920314 | Little Company of Mary Hospital of Indiana Inc | Surgery | 1025 1st Ave W Ste B, Jasper, IN 47546-3217 | 2020-07-23 |
1013568724 | Amber D Petty | Surgery | 2401 W University Ave Ste 403, Muncie, IN 47303-3428 | 2019-09-24 |
1972162246 | Christopher Anthony Lawton | Surgery | 635 Barnhill Dr Ste 116, Indianapolis, IN 46202-5126 | 2019-06-11 |
1013436922 | Stephen Neil Quigley | Surgery | 550 University Blvd # Uh1295, Indianapolis, IN 46202-5149 | 2017-09-12 |
1821512138 | Decatur County Memorial Hospital | Surgery | 731 N Lincoln St, Greensburg, IN 47240-1328 | 2017-07-28 |
1881120434 | Henry Lee Roberts | Surgery | 545 Barnhill Dr # 125, Indianapolis, IN 46202 | 2017-05-02 |
1891189171 | Werner Heinrich Henning | Surgery | 1230 Colinbrook Cir, Greenwood, IN 46143-3608 | 2015-03-24 |
1962806851 | Shotaro Sano | Surgery | 2451 Intelliplex Dr Ste 280, Shelbyville, IN 46176-8580 | 2014-10-21 |
1336540814 | Fredrick Allen Hillis | Surgery | 374 S Shore Dr, Culver, IN 46511-8908 | 2014-09-15 |
Find all providers with the same taxonomy |
City | SOUTH BEND |
Zip Code | 46601 |
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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.