Individual provider Active NPI

Ryan Patrick Koch, D.C.

  • Chiropractor
  • Bismarck, ND
National Provider Identifier
1437200839
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
785 Issued in ND
Practice address
2600 Gateway Ave
Suite 2
Bismarck, ND 58503-0568
Phone
(701) 751-1161
NPI assigned
Jan 15, 2007
Last updated
Feb 29, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 785 ND Primary

Addresses

Primary practice location

2600 Gateway Ave
Suite 2
Bismarck, ND 58503-0568

Mailing address

2600 Gateway Ave
Suite 2
Bismarck, ND 58503-0568
Phone (701) 751-1161

Other identifiers 2

IdentifierTypeStateIssuer
30415OtherBCBS ND PROVIDER NUMBER
07066-001OtherNDBCBS ND CLINIC/GROUP #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070305000239 ND Practitioner - Chiropractic 2264534643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2600 Gateway Ave
Suite 2
Bismarck, ND 58503-0513
Phone (701) 751-1161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
785NDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Ryan Koch, P.C. Chiropractor CurrentSince Jan 1, 2008 Accepting new patients
Capital Chiropractic PC Chiropractor PastSince Oct 1, 2003 Accepting new patients

Locations

2600 Gateway Ave
Ste 2
Bismarck, ND 58503
Phone (701) 214-6818

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1437200839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 GATEWAY AVE",
            "address_2": "SUITE 2",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030568",
            "telephone_number": "701-751-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 GATEWAY AVE",
            "address_2": "SUITE 2",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030568",
            "telephone_number": "701-751-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "RYAN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ND PROVIDER NUMBER",
            "identifier": "30415",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ND CLINIC/GROUP #",
            "identifier": "07066-001",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; 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.

Verify at the official NPI Registry.