NPIMap

Individual provider Active NPI

Sean Koch, MD

  • Family Medicine Physician
  • Wynne, AR
National Provider Identifier
1184112112
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-15515 Issued in AR
Practice address
1920 Falls Blvd N
Wynne, AR 72396-4027
Phone
(870) 587-0800
NPI assigned
Apr 25, 2018
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-15515 AR Primary

Addresses

Primary practice location

1920 Falls Blvd N
Wynne, AR 72396-4027

Mailing address

924 Ar-77
Marion, AR 72364
Phone (870) 739-8670

Other practice location 1

924 Ar-77
Marion, AR 72364
Phone (870) 739-8670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220629003611 AR Practitioner - Family Practice 3971854530 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harmony Health Clinic Wynne, PLLCGroup PAC ID 6305217688, 11 clinicians
Mitchell Family Medicine LLCGroup PAC ID 1850633074, 9 clinicians

Practice addresses (Care Compare)

1920 Falls Blvd N
Wynne, AR 72396-4027
Phone (870) 587-0800

924 State Hwy 77
Marion, AR 72364-9004
Phone (870) 739-8670

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-15515ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mitchell Family Medicine, LLC Family Medicine CurrentSince Jun 20, 2022 Accepting new patients
Harmony Health Clinic Wynne, PLLC Family Medicine CurrentSince Nov 1, 2022 Accepting new patients
Harmony Health Clinic Wynne, PLLC Family Medicine CurrentSince Nov 1, 2022 Accepting new patients

Locations

130 J F Blvd
Lonoke, AR 72086
Phone (501) 436-0222

924 State Highway 77
Marion, AR 72364
Phone (870) 739-5310

437 S Country Club Rd
Osceola, AR 72370
Phone (870) 563-0820

1920 Falls Blvd N
Wynne, AR 72396
Phone (870) 587-0800

Interoperability endpoints

  • Direct secure messaging: skoch517432@direct.bmhcc.org

Organizations & group practices 3

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.

Hospital & facility affiliations 10

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": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1184112112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 AR-77",
            "city": "MARION",
            "state": "AR",
            "postal_code": "72364",
            "telephone_number": "870-739-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 FALLS BLVD N",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723964027",
            "telephone_number": "870-587-0800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "924 AR-77",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "AR",
            "postal_code": "72364",
            "country_code": "US",
            "telephone_number": "870-739-8670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCH",
        "first_name": "SEAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-25",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-15515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynne, AR

Sources for this page

Verify at the official NPI Registry.