Koch Facial Plastic Surgery PC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

KOCH FACIAL PLASTIC SURGERY PC

Practice address

4855 Mills Civic Parkway #100
West Des Moines, IA 50265

Phone

(515) 277-5555

Fax

(515) 277-0060

NPI assigned

Jul 29, 2013

Last updated

Jan 12, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brent Koch, MD

Title

Owner/MD

Phone

(515) 277-5555

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael P. Carlisle, M.D.

  • Plastic Surgery Physician
  • West Des Moines, IA
  • NPI 1295950376

  Otolaryngology

  Medicare reassignment Care Compare group NPD
• Cody A Koch, MD, PHD

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • West Des Moines, IA
  • NPI 1316149925
  Medicare reassignment Care Compare group
• Brooke Herman, PA-C

  • Physician Assistant
  • West Des Moines, IA
  • NPI 1891705612
  Medicare reassignment
• Pamela Sue Banyas, PA-C

  • Physician Assistant
  • Des Moines, IA
  • NPI 1396871372
  NPD (past)
• Jeffrey S Carithers, MD

  • Facial Plastic Surgery Physician
  • Des Moines, IA
  • NPI 1295732931
  NPD (past)
• Darya Ann Hansen, ARNP

  • Nurse Practitioner
  • Ankeny, IA
  • NPI 1710552112
  NPD (past)
• Brenton B Koch, MD

  • Facial Plastic Surgery Physician
  • West Des Moines, IA
  • NPI 1487651303
  NPD (past)

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1316389653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 MILLS CIVIC PARKWAY #100",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "50265",
            "telephone_number": "515-277-5555",
            "fax_number": "515-277-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 MILLS CIVIC PARKWAY #100",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "50265",
            "telephone_number": "515-277-5555",
            "fax_number": "515-277-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOCH FACIAL PLASTIC SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-29",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "515-277-5555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KMC NP LLC (Foxhole Health & Consulting, PLLC)
• Gabrielle Renee Knight, LMSW
• Patricia Sue Knight, RN
• Angela Knoblauch, DO
• Scott Joseph Knoer, RPH
• Brenton B Koch, MD
• Cameron Mansfield Koch, MD
• Cody A Koch, MD, PHD
• Ian Koch, D.O.
• Nathan Koch

• Otolaryngology Physician in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Otolaryngology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.