KELLY LEE KOENIG (NPI# 1861710576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861710576 |
| Entity Type | Individual |
| Full Name | KELLY LEE KOENIG |
| Credential | D.O. |
| Practice Address |
120 E Harris Ave San Angelo TX 76903-5904 |
| Mailing Address |
Po Box 22000 San Angelo TX 76902-7200 |
| Practice Telephone | 3256581511 |
| Practice Fax Number | 3254812166 |
| Mailing Telephone | 3256581511 |
| Mailing Fax Number | 3254812166 |
| Enumeration Date | 2010-05-06 |
| Last Update Date | 2015-01-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Q0294 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 8EN017 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083184154 | Kelly Ann Koenig | Specialist/Technologist | 1376 Bream Ave, Manning, SC 29102-8456 | 2018-11-30 |
| 1942746730 | Kelly Koenig | Physician Assistant | 1 Childrens Plz, Dayton, OH 45404-1873 | 2017-01-17 |
| 1033451117 | Kelly Nicole Koenig | Dermatology | 200 W Pearl St, Findlay, OH 45840 | 2013-03-26 |
| Street Address |
120 E HARRIS AVE |
| City | SAN ANGELO |
| State | TX |
| Zip Code | 76903-5904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467455113 | Michael F Carper | Pharmacist | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2005-05-24 |
| 1083185565 | Stephanie Lauren Hayes | Nurse Practitioner | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2018-12-10 |
| 1326556283 | Erin E Miller | Occupational Therapist | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2018-01-12 |
| 1700398484 | Jacob Webster | Physician Assistant | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2017-11-02 |
| 1518322890 | Justina Casiano | Dietitian, Registered | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2015-12-30 |
| 1114392040 | Megan Webb | Dietitian, Registered | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2015-12-03 |
| 1316312341 | Chelsie Jenna Barnes | Dietitian, Registered | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2015-12-02 |
| 1881069912 | Tiffany Rohmfeld | Dietitian, Registered | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2015-12-01 |
| 1164897252 | Nicole Lusk | Dietitian, Registered | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2015-12-01 |
| 1750756888 | Jessica Butts | Dietitian, Registered | 120 E Harris Ave, Food & Nutrition Dept, San Angelo, TX 76903-5904 | 2015-12-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306386081 | The Waterford Wellness Spa | Clinic/Center | 602 S. Abe, San Angelo, TX 76903 | 2017-03-01 |
| 1154782415 | Jerrica Elayne Escobedo | Counselor | 424 South Oakes, San Angelo, TX 76903 | 2016-03-15 |
| 1578923868 | Wal-mart Stores Texas, LLC | Technician/Technologist | 3440 S. Bryant Blvd, San Angelo, TX 76903 | 2016-02-29 |
| 1821475161 | San Angelo Dental, Pllc | Dentist | 614 29th Street, Suite, Sanangelo, TX 76903 | 2015-05-06 |
| 1033549670 | Tina Faye Luck | Nurse Practitioner | 36 E Twohig Ave Ste 1100, San Angelo, TX 76903 | 2013-11-18 |
| 1295087294 | Tara Joiner | Counselor | 27 W Beauregard Ave, San Angelo, TX 76903 | 2012-10-15 |
| 1225380728 | Tanya L Favor | Physician Assistant | 215 E. College, San Angelo, TX 76903 | 2012-10-08 |
| 1336459551 | Education Service Center | Social Worker | 612 S Irene, San Angelo, TX 76903 | 2010-10-21 |
| 1508194176 | Pay and Save Inc | Pharmacy | 1926 N. Bryant Blvd., San Angelo, TX 76903 | 2009-11-19 |
| 1326375734 | Pay and Save Inc | Pharmacy | 2 S. Main St., San Angelo, TX 76903 | 2009-11-05 |
| Find all providers in zip 76903 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891921409 | John George Speck | Emergency Medicine | 5709 Sherwood Way, San Angelo, TX 76901-5643 | 2009-06-09 |
| 1043424021 | Michael Patrick Strayer | Emergency Medicine | 3501 Kinickerbocker Rd, San Angelo, TX 76904-0000 | 2007-05-09 |
| 1952458986 | Brian David Rappe | Emergency Medicine | 2613 Southland Blvd, #10, San Angelo, TX 76904-7551 | 2007-01-04 |
| 1215957873 | David Charles Herbert | Emergency Medicine | 1842 South Concho Dr, San Angelo, TX 76904-7970 | 2006-07-19 |
| 1538101571 | Michael Ray Hambrick | Emergency Medicine | 2142 Sunset Drive, San Angelo, TX 76904 | 2006-06-12 |
| 1154322014 | Brett Jason Nile | Emergency Medicine | 3101 Rigdecrest Lane, San Angelo, TX 76904 | 2005-08-02 |
| 1972062545 | Concho Valley Emergency Physicians Pllc | Emergency Medicine | 5709 Sherwood Way, San Angelo, TX 76901-5643 | 2019-03-13 |
| 1679912083 | Chali Mulenga | Emergency Medicine | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2013-06-19 |
| 1922245067 | Del Mar Emergency Physicians, LLP | Emergency Medicine | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2009-01-12 |
| 1457510786 | Kimrey Janiece Daniel | Emergency Medicine | 120 E Harris Ave, San Angelo, TX 76903-5904 | 2008-06-02 |
| Find all providers in SAN ANGELO | ||||
| City | SAN ANGELO |
| Zip Code | 76903 |
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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.