NPIMap

Individual provider Active NPI

Karen Kelly Koch, OTR

  • Occupational Therapist
  • Coloma, MI
National Provider Identifier
1003965468
Registry record updated May 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201003832 Issued in MI
Practice address
3243 Birch Ave
Coloma, MI 49038-9117
Phone
(269) 978-8340
Fax
(866) 576-3284
NPI assigned
Jan 8, 2007
Last updated
May 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2020

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201003832 MI Primary
Pediatric Occupational Therapist 225XP0200X NU
Gerontology Occupational Therapist 225XG0600X NU
Gerontology Occupational Therapist 225XG0600X 5201003832 MI
Environmental Modification Occupational Therapist 225XE0001X 5201003832 MI
Environmental Modification Occupational Therapist 225XE0001X NU
Feeding, Eating & Swallowing Occupational Therapist 225XF0002X 5201003832 MI
Low Vision Occupational Therapist 225XL0004X NU

Addresses

Primary practice location

3243 Birch Ave
Coloma, MI 49038-9117

Mailing address

3243 Birch Ave
Coloma, MI 49038-9117
Phone (269) 978-8340

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

Practice roles

OrganizationSpecialtyStatusNew patients
Essential Luxuries, LLC CurrentSince Jun 30, 2020 Accepting new patients

Locations

3243 Birch Ave
Coloma, MI 49038
Phone (269) 615-2559

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589673600000",
    "number": "1003965468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3243 BIRCH AVE",
            "city": "COLOMA",
            "state": "MI",
            "postal_code": "490389117",
            "telephone_number": "269-978-8340",
            "fax_number": "866-576-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3243 BIRCH AVE",
            "city": "COLOMA",
            "state": "MI",
            "postal_code": "490389117",
            "telephone_number": "269-978-8340",
            "fax_number": "866-576-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "KAREN",
        "middle_name": "KELLY",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-05-17",
        "certification_date": "2020-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201003832",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "MI",
            "license": "5201003832",
            "primary": false
        },
        {
            "code": "225XE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": "MI",
            "license": "5201003832",
            "primary": false
        },
        {
            "code": "225XE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": "MI",
            "license": "5201003832",
            "primary": false
        },
        {
            "code": "225XL0004X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Low Vision",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coloma, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.