Individual provider Active NPI

Kristen Bieri Koch, PA-C

  • Medical Physician Assistant
  • Spartanburg, SC
National Provider Identifier
1356653968
Registry record updated Nov 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1479 Issued in SC
Practice address
126 Dillon Dr
Spartanburg, SC 29307-1018
Phone
(864) 327-1212
NPI assigned
Jul 12, 2010
Last updated
Nov 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1479 SC Primary

Addresses

Primary practice location

126 Dillon Dr
Spartanburg, SC 29307-1018

Mailing address

304 Faulkner Dr
Moore, SC 29369-8823
Phone (864) 706-0895

Other practice location 1

1530 N Limestone St
Gaffney, SC 29340-4742
Phone (864) 487-4271

Other practice location 2

1700 Skylyn Dr
Spartanburg, SC 29307
Phone (864) 573-3123

Other names 1

  • Kristen Meredith Bieri Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110405000184 SC Practitioner - Physician Assistant 1153505870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foothills Nephrology PCGroup PAC ID 0244122521, 7 clinicians

Practice addresses (Care Compare)

126 Dillon Dr
Spartanburg, SC 29307-1018
Phone (864) 327-1212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1479SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Emergency Service Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1356653968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 FAULKNER DR",
            "city": "MOORE",
            "state": "SC",
            "postal_code": "293698823",
            "telephone_number": "864-706-0895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 DILLON DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071018",
            "telephone_number": "864-327-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1530 N Limestone St",
            "address_purpose": "LOCATION",
            "city": "Gaffney",
            "state": "SC",
            "postal_code": "293404742",
            "country_code": "US",
            "telephone_number": "864-487-4271",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 Skylyn Dr",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "29307",
            "country_code": "US",
            "telephone_number": "864-573-3123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCH",
        "first_name": "KRISTEN",
        "middle_name": "BIERI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-12",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "1479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "BIERI",
            "middle_name": "MEREDITH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.