Nita Kofchock

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP60291694 Issued in WA

Practice address

2802 E District St
Tucson, AZ 85714-2081

Phone

(520) 301-2400

NPI assigned

Nov 20, 2009

Last updated

Jun 1, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Nurse Practitioner

State licenses

Practice roles

Locations (25 of 31)

Interoperability endpoints

• Direct secure messaging: nita.kofchock.1@16211.direct.athenahealth.com
• Direct secure messaging: nita.kofchock.p1@direct.cbridges.nextgenshare.com
• Direct secure messaging: nkofchock492827@direct.multicare.org

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.

• Allina Health System

  dba Allina Health Buffalo Specialty Clinic

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  NPD
• Allina Health System

  dba Lamberton Clinic - New Ulm Medical Center

  • Family Medicine Physician
  • Lamberton, MN
  • NPI 1467090159
  NPD
• Allina Health System

  dba Allina Health TeleRheumatology

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD
• Legacy Clinics LLC

  dba Legacy Medical Group Firwood

  • Rural Health Clinic/Center
  • Sandy, OR
  • NPI 1730472192
  NPD
• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272
  NPD
• Options Counseling Services of Oregon

  dba Options Counseling and Family Services

  • Mental Health Counselor
  • Eugene, OR
  • NPI 1548275217
  NPD
• Ria Health PC

  • Addiction Medicine (Internal Medicine) Physician
  • San Francisco, CA
  • NPI 1326539404
  NPD
• Trinity Health of New England Provider Network Organization Inc

  dba Trinity Health Of New England Medical Group

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1003882812

  Nurse Practitioner

  NPD
• Trinity Health of New England Provider Network Organization Inc

  dba Trinity Health Of New England Medical Group

  • Internal Medicine Physician
  • Waterville, ME
  • NPI 1134779531
  NPD
• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  NPD
• University of Utah Adult Services

  dba University of Utah Hospital Radiology Department

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD
• University of Utah Adult Services

  dba Huntsman Cancer Hospital Rad. Onc.

  • Radiation Oncology Physician
  • Salt Lake City, UT
  • NPI 1881098697
  NPD

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

{
    "created_epoch": "1258675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1174851695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E EARLL DR STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122647",
            "telephone_number": "602-808-2800",
            "fax_number": "602-808-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 E DISTRICT ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857142081",
            "telephone_number": "520-301-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1545 Harbeck Rd",
            "address_purpose": "LOCATION",
            "city": "Grants Pass",
            "state": "OR",
            "postal_code": "975275605",
            "country_code": "US",
            "telephone_number": "541-479-2371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1722 S Lewis Rd",
            "address_purpose": "LOCATION",
            "city": "Camarillo",
            "state": "CA",
            "postal_code": "930128520",
            "country_code": "US",
            "telephone_number": "805-366-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOFCHOCK",
        "first_name": "NITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-20",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP8509",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60291694",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "201710096NP-PP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE LICENSE",
            "identifier": "AP60291694",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094362",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Geoffrey Cornell Koelling, DMD
• Le Roy M Koenig, ANP-C, GNP
• Tynisha Marie Koenigsaecker, MD
• Billi Jo Koepke, RNFA, FNP-C
• Adam Charles Koetter
• Janet Elizabeth Koharik, FNP-BC
• Annette Kohl, LAC
• Chad Andrew Kohl, MD
• David E Kohler-Edwards, IDMT
• Aparna Kohli, RDN, CD-N

• Psychiatric/Mental Health Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.