Active NPI
Paul Erik Koch, D.C.
- Chiropractor
- Sewell, NJ
National Provider Identifier
1336177286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- MC04368
- Practice address
- 259 Fish Pond Rd
Ste. 8
Sewell, NJ 08080-3046 - Phone
- (856) 582-7800
- Fax
- (856) 582-7557
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | MC04368 | NJ | Primary |
Addresses
Primary practice location
259 Fish Pond Rd
Ste. 8
Sewell, NJ 08080-3046
Mailing address
662 Jackson Rd
Mullica Hill, NJ 08062-2402
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120109000105 | NJ | Practitioner - Chiropractic | 2062688302 | Practice locations: Sewell, NJ |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
259 Fish Pond Rd
Sewell, NJ 08080-3046
Phone (856) 582-7800
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC04368 | NJ | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318809600000",
"number": "1336177286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "662 JACKSON RD",
"city": "MULLICA HILL",
"state": "NJ",
"postal_code": "080622402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 FISH POND RD",
"address_2": "STE. 8",
"city": "SEWELL",
"state": "NJ",
"postal_code": "080803046",
"telephone_number": "856-582-7800",
"fax_number": "856-582-7557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOCH",
"first_name": "PAUL",
"middle_name": "ERIK",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2011-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "MC04368",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sewell, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.