Camille Marie Koch, DPT

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

Practice address

9651 Prairie Ridge Blvd
Pleasant Prairie, WI 53158-1948

Phone

(262) 333-8158

NPI assigned

Jun 6, 2019

Sex

Female

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

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paxxon Healthcare Services LLCGroup PAC ID 8325959554, 153 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Paxxon Healthcare Services LLC

  • Physical Therapist
  • Menomonee Falls, WI
  • NPI 1003174087
  Medicare reassignment Care Compare group NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Menomonee Falls, WI
  • NPI 1245755487
  Medicare reassignment NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462
  NPD
• Paxxon Healthcare Services LLC

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1336808146
  NPD

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1104485853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4885 MAGNOLIA LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554422078",
            "telephone_number": "612-816-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9651 PRAIRIE RIDGE BLVD",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531581948",
            "telephone_number": "262-333-8158"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6600 River Pkwy",
            "address_purpose": "LOCATION",
            "city": "Wauwatosa",
            "state": "WI",
            "postal_code": "532133292",
            "country_code": "US",
            "telephone_number": "414-476-8787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCH",
        "first_name": "CAMILLE",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-06",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdul Sami Khan, MD
• Holly Marie Kirby
• Joseph Kitten, DPT
• Kristin L Klimisch, PNP
• Hannah Knutson, PT
• Josephine Kristiansen, RPH, PHARMD, BCPS
• Kelly Kuennen
• Jill Marie Kunicki, PHARMD
• Lisa N Kurman
• Markian J Kuzycz, MD

• Geriatric Physical Therapist in Pleasant Prairie, WI
• Providers in Pleasant Prairie, WI by specialty
• Geriatric Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.