Individual provider Active NPI

Christopher Jonathan Koch, DC

  • Chiropractor
  • Peoria, AZ
National Provider Identifier
1265569834
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5620 Issued in AZ
Practice address
7717 W Deer Valley Rd
Suite 135
Peoria, AZ 85382-2102
Phone
(623) 512-4040
Fax
(623) 512-4040
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5620 AZ Primary

Addresses

Primary practice location

7717 W Deer Valley Rd
Suite 135
Peoria, AZ 85382-2102

Mailing address

7717 W Deer Valley Rd
Suite 135
Peoria, AZ 85382-2102
Phone (623) 512-4040

Other identifiers 2

IdentifierTypeStateIssuer
AZ0243770OtherAZBLUE CROSS BLUE SHIELD
23-22036OtherAZSTATE COMPENSATION FUND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060309000155 AZ Practitioner - Chiropractic 4587671953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Chiropractic Center, PCGroup PAC ID 2466439948, 3 clinicians

Practice addresses (Care Compare)

7717 W Deer Valley Rd
Suite 135
Peoria, AZ 85382-2102
Phone (623) 512-4040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1265569834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7717 W DEER VALLEY RD",
            "address_2": "SUITE 135",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853822102",
            "telephone_number": "623-512-4040",
            "fax_number": "623-512-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7717 W DEER VALLEY RD",
            "address_2": "SUITE 135",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853822102",
            "telephone_number": "623-512-4040",
            "fax_number": "623-512-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "CHRISTOPHER",
        "middle_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0243770",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE COMPENSATION FUND",
            "identifier": "23-22036",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.