Individual provider Active NPI

Kristopher Robert Koch, MD,MPH

  • Internal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1174985352
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R9797 Issued in TX
Practice address
14100 Nacogdoches Rd Ste 116
San Antonio, TX 78247-1907
Phone
(210) 653-8989
Fax
(210) 590-4608
NPI assigned
Mar 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R9797 TX Primary

Addresses

Primary practice location

14100 Nacogdoches Rd Ste 116
San Antonio, TX 78247-1907

Mailing address

14100 Nacogdoches Rd Ste 116
San Antonio, TX 78247-1907
Phone (210) 653-8989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20190722003458 TX Practitioner - Internal Medicine 7315238060 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical School at San Antonio, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

14100 Nacogdoches Rd
116 Wellmed at Northern Hills
San Antonio, TX 78247-1907
Phone (210) 653-8989

Hospital & facility affiliations

  • Christus Vna Homecare San Antonio Home health agency, San Antonio, TX, CCN 457777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R9797TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Clinic Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
Wellmed Medical Group, P.a. Internal Medicine CurrentSince Jul 7, 2019 Accepting new patients
Wellmed Medical Group, PA Internal Medicine Current Accepting new patients
Wellmed Medical Group, P.a. Internal Medicine CurrentSince Jul 7, 2019 Accepting new patients

Locations

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

120 E Harris Ave
San Angelo, TX 76903
Phone (325) 653-6741

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

14100 Nacogdoches Rd
Ste 116
San Antonio, TX 78247
Phone (210) 491-8136

Interoperability endpoints

  • Direct secure messaging: kkoch54250@shannonhealth.direct-ci.com
  • Direct secure messaging: kristopher.koch@wellmed.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1174985352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 NACOGDOCHES RD STE 116",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782471907",
            "telephone_number": "210-653-8989",
            "fax_number": "210-590-4608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14100 NACOGDOCHES RD STE 116",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782471907",
            "telephone_number": "210-653-8989",
            "fax_number": "210-590-4608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "KRISTOPHER",
        "middle_name": "ROBERT",
        "credential": "MD,MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-25",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R9797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.