Charles L. Kock, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

A10076 Issued in LA

Practice address

201 Denning Dr
Houma, LA 70360-3977

Phone

(985) 855-4829

NPI assigned

Dec 9, 2005

Last updated

Jan 6, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mr. Charles Lewis Kock Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charlie.kock@sfhga.gadirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. Francis Cardiovascular Institute, LLC

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  • Columbus, GA
  • NPI 1598109852
  NPD
• Cardiovascular Institute of the South, LLC

  • Cardiovascular Disease Physician
  • Houma, LA
  • NPI 1982689113

  Surgical

  NPD (past)
• St. Francis Physician Practices LLC

  • Gastroenterology Physician
  • Columbus, GA
  • NPI 1609655646
  NPD (past)

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1356326631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 DENNING DR.",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "70360",
            "telephone_number": "985-855-4829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 DENNING DR",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703603977",
            "telephone_number": "985-855-4829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCK",
        "first_name": "CHARLES",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "LA",
            "license": "A10076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "970006535",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1624845",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLES",
            "last_name": "KOCK",
            "middle_name": "LEWIS",
            "prefix": "MR.",
            "credential": "PHYSICIAN, ASSISTANT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lisa Jackson Kirk
• Erin W Klingman, RN
• Aaron Daniel Knight, MD
• Ruth Knight, M.S., L-SLP, CCC-SLP
• Hannah Knott, DDS, BS
• Kelsey Koenig
• Tania Multani Kohal, MD
• Ji Yoon Kong
• Jessica Clair Koster, LPC
• Chrissy Kraemer

• Surgical Physician Assistant in Houma, LA
• Providers in Houma, LA by specialty
• Surgical Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.