Ian Michael Koch

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510

Phone

(954) 335-4400

NPI assigned

Mar 28, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1386348084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10515 N HADDONSTONE PL",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925953",
            "telephone_number": "262-389-7917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S ANDREWS AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162510",
            "telephone_number": "954-335-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2950 Cleveland Clinic Blvd",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "FL",
            "postal_code": "333313625",
            "country_code": "US",
            "telephone_number": "954-659-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCH",
        "first_name": "IAN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Knickerbocker, MD
• Joann Knight, CERTIFIED COUNSELOR
• Namiko Noelli Knight, DPT
• Heather Knoeferl, B.S., OTR
• Melanie Rose Knoepfler
• Lynanne Joyce Koenig, MOT OTR/L
• Shannen Kogos, PT, DPT
• Laura L Kohn, LMHC
• Marie M Kolattukudy, MD
• Paul W Kolbert, MD

• Student in an Organized Health Care Education/Training Program in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Student in an Organized Health Care Education/Training Program in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.