Max Robert Couch, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041567463 Issued in IL

Practice address

1500 Bridgeport Way
Suffolk, VA 23435-1956

Phone

(217) 371-0066

NPI assigned

Nov 5, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1063235331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 BRIDGEPORT WAY APT 212",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351961",
            "telephone_number": "217-371-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 BRIDGEPORT WAY",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351956",
            "telephone_number": "217-371-0066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "730 N Jackson St",
            "address_purpose": "LOCATION",
            "city": "Pittsfield",
            "state": "IL",
            "postal_code": "623631219",
            "country_code": "US",
            "telephone_number": "217-371-0066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COUCH",
        "first_name": "MAX",
        "middle_name": "ROBERT",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041567463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Registered Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.