Active NPI
Angela Esther Koich, MS, LAT, ATC
- Athletic Trainer
- Edina, MN
National Provider Identifier
1326524414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 8244
- Practice address
- 8100 W 78TH St
Edina, MN 55439-2516 - Phone
- (952) 946-9777
- NPI assigned
- Jul 12, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 8244 | MN | Primary |
Addresses
Primary practice location
8100 W 78TH St
Edina, MN 55439-2516
Mailing address
1414 Juliet Ave
Saint Paul, MN 55105-2565
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8244 | MN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531353600000",
"number": "1326524414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1414 JULIET AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551052565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8100 W 78TH ST",
"city": "EDINA",
"state": "MN",
"postal_code": "554392516",
"telephone_number": "952-946-9777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOICH",
"first_name": "ANGELA",
"middle_name": "ESTHER",
"credential": "MS, LAT, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-12",
"last_updated": "2018-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MN",
"license": "8244",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.