Active NPI
Scott R. Koch, M.D.
- Diagnostic Radiology Physician
- Louisville, KY
National Provider Identifier
1285650788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 24691
- Practice address
- 200 Abraham Flexner Way
Louisville, KY 40202-1818 - Phone
- (502) 583-2731
- Fax
- (502) 583-2733
- NPI assigned
- Jul 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 24691 | KY | Primary |
Addresses
Primary practice location
200 Abraham Flexner Way
Louisville, KY 40202-1818
Mailing address
222 S 1St St
Louisville, KY 40202-5404
Phone (502) 583-2731
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000062496 | Other | KY | ANTHEM BLUE FACET |
| 64246911 | Medicaid | KY | |
| XPY202624 | Medicaid | CA | |
| 7611350 | Medicaid | NC | |
| 01773591 | Medicaid | NY | |
| 0197571000 | Medicaid | WV | |
| 2126489 | Medicaid | OH | |
| 1055252 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24691 | KY | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1285650788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 S 1ST ST",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402025404",
"telephone_number": "502-583-2731",
"fax_number": "502-583-2733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 ABRAHAM FLEXNER WAY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021818",
"telephone_number": "502-583-2731",
"fax_number": "502-583-2733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOCH",
"first_name": "SCOTT",
"middle_name": "R.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-15",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "KY",
"license": "24691",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE FACET",
"identifier": "000000062496",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64246911",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "XPY202624",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7611350",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01773591",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0197571000",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2126489",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1055252",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.