Jack L. Koch Jr., M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

27427 Issued in TN

Practice address

1507 16TH Ave S
Nashville, TN 37212-2905

Phone

(615) 515-7775

Fax

(615) 523-1483

NPI assigned

Jun 28, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athena Consulting and Psychological Services, PLLCGroup PAC ID 5294719795, 60 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Athena Consulting and Psychological Services, PLLC

  • Clinical Psychologist
  • Nashville, TN
  • NPI 1336292465

  Psychiatry

  Medicare reassignment Care Compare group NPD
• Clarksville Behavioral Health, LLC

  • Psychologist
  • Clarksville, TN
  • NPI 1174965420
  NPD (past)
• Neuroscience and TMS Treatment Center PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Nashville, TN
  • NPI 1225465107

  Psychiatry

  NPD (past)
• Richland Creek Psychiatric Assoc. LLP

  • Clinical Social Worker
  • Nashville, TN
  • NPI 1497899363
  NPD (past)

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1114923737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 16TH AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372122905",
            "telephone_number": "615-515-7775",
            "fax_number": "615-523-1483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 16TH AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372122905",
            "telephone_number": "615-515-7775",
            "fax_number": "615-523-1483"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 Hazel Path Ste 4",
            "address_purpose": "LOCATION",
            "city": "Hendersonville",
            "state": "TN",
            "postal_code": "370753888",
            "country_code": "US",
            "telephone_number": "615-320-1155",
            "fax_number": "615-320-1177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "775 Weatherly Dr Ste F",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370438915",
            "country_code": "US",
            "telephone_number": "615-320-1155",
            "fax_number": "615-320-1177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 Athens Way Ste 104",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372281351",
            "country_code": "US",
            "telephone_number": "615-320-1155",
            "fax_number": "615-320-1177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCH",
        "first_name": "JACK",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TN",
            "license": "27427",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "27427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myat Kyaw Ko, MD
• Kenji Ryan Kobayashi, MD
• Emily Kobin, MD
• Irene Ann Koc, MD
• Christopher Troy Koch, MD
• Julianne Koch, O.D.
• Joseph John Kochelek, LCSW
• Shwetha Kishore Kochi, MD
• Rodney Morse Kochtitzky, M.DIV.
• Angella Kocian, PSY.D., LP

• Psychiatry Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Psychiatry Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.