Organization Active NPI

Joseph Koch, M.D., PLLC

  • Family Medicine Physician
  • Lufkin, TX
National Provider Identifier
1255697306
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JOSEPH KOCH, M.D., PLLC
Practice address
1224 S John Redditt Dr
Lufkin, TX 75904-4377
Phone
(936) 639-4393
Fax
(877) 916-5022
NPI assigned
Apr 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Authorized official

Name
Joseph Alan Koch, MDNPI 1386970523
Title
President
Phone
(936) 639-4393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1224 S John Redditt Dr
Lufkin, TX 75904-4377

Mailing address

1224 S John Redditt Dr
Lufkin, TX 75904-4377
Phone (936) 639-4393

Other names 1

  • Tall Pines Family Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120917000396 TX Part B Supplier - Clinic/Group Practice 0648428615 Receives reassigned benefits from 5 practitioners
Practice locations: Lufkin, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2039354Tall Pines Family Clinic1224 S John Redditt Drive, Lufkin, TX 75904Provider-performed microscopyApr 5, 2028

National Provider Directory

National Provider Directory

Locations

10 Medical Center Blvd
Ste C
Lufkin, TX 75904
Phone (936) 639-4393

1201 W Frank Ave
#D
Lufkin, TX 75904
Phone (936) 639-4393

201 S John Redditt Dr
Lufkin, TX 75904
Phone (936) 632-3346

1224 S John Redditt Dr
Lufkin, TX 75904
Phone (512) 588-6011

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689120000000",
    "number": "1255697306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 S JOHN REDDITT DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759044377",
            "telephone_number": "936-639-4393",
            "fax_number": "877-916-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 S JOHN REDDITT DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759044377",
            "telephone_number": "936-639-4393",
            "fax_number": "877-916-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH KOCH, M.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-03",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-639-4393",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tall Pines Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tall Pines Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lufkin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.