Individual provider Active NPI

Diane Abby Koch, PHD

  • Psychologist
  • Tampa, FL
National Provider Identifier
1164576179
Registry record updated Aug 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY4230 Issued in FL
Practice address
312 E 7TH Ave
Tampa, FL 33602-2300
Phone
(813) 399-1625
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY4230 FL Primary

Addresses

Primary practice location

312 E 7TH Ave
Tampa, FL 33602-2300

Mailing address

16105 Cadbury CT
Tampa, FL 33647
Phone (813) 632-3551

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
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Learing Psychologist Current Accepting new patients
Therakids Plus, Inc. Past Accepting new patients
Florida Neurocognitive Development Center Past Accepting new patients
Child and Family Learning Past Accepting new patients
Therakids Plus Center for Children & Adults Past Accepting new patients

Locations

10549 N Florida Ave
Ste G
Tampa, FL 33612
Phone (352) 678-1881

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407801600000",
    "number": "1164576179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16105 CADBURY CT",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33647",
            "telephone_number": "813-632-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 E 7TH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336022300",
            "telephone_number": "813-399-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "DIANE",
        "middle_name": "ABBY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2014-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY4230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; 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.