Individual provider Active NPI

Joshua Layne Koch, D.C.

  • Rehabilitation Chiropractor
  • Midwest City, OK
National Provider Identifier
1215115068
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
3870 Issued in OK
Practice address
1712 S Post Rd Ste B
Midwest City, OK 73130-6614
Phone
(405) 455-7555
Fax
(405) 455-7556
NPI assigned
Feb 4, 2008
Last updated
Nov 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 3870 OK Primary

Addresses

Primary practice location

1712 S Post Rd Ste B
Midwest City, OK 73130-6614

Mailing address

2304 S Post Rd
Midwest City, OK 73130-7524
Phone (405) 455-7555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20081002000104 OK Practitioner - ChiropracticPractitioner - Physical Medicine and Rehabilitation 6608943857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Physical Medicine and Rehabilitation
Education
Logan College of Chiropractic, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2304 S Post Rd
Midwest City, OK 73130-7524
Phone (405) 455-7555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3870OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Chiropractic and Rehabilitation Clinic P L L C Rehabilitation CurrentSince May 1, 2008 Accepting new patients

Locations

1712 S Post Rd
Ste B
Midwest City, OK 73130
Phone (405) 394-4831

2304 S Post Rd
Oklahoma City, OK 73130
Phone (405) 455-7555

5601 SE 67th St
Ste B
Oklahoma City, OK 73135
Phone (405) 455-7101

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1215115068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 S POST RD",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731307524",
            "telephone_number": "405-455-7555",
            "fax_number": "405-455-7556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 S POST RD STE B",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731306614",
            "telephone_number": "405-455-7555",
            "fax_number": "405-455-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "JOSHUA",
        "middle_name": "LAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-04",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "OK",
            "license": "3870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midwest City, OK

Sources for this page

Verify at the official NPI Registry.