Individual provider Active NPI

Rachel L Couch, ARNP

  • Pediatrics Physician
  • Fort Walton Beach, FL
National Provider Identifier
1477034114
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
APRN9439416 Issued in FL
Practice address
1005 Mar Walt Dr
Fort Walton Beach, FL 32547-6707
Phone
(850) 863-8203
Fax
(850) 863-8203
NPI assigned
Aug 21, 2018
Last updated
Aug 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X APRN9439416 FL Primary

Addresses

Primary practice location

1005 Mar Walt Dr
Fort Walton Beach, FL 32547-6707

Mailing address

1005 Mar Walt Dr
Fort Walton Beach, FL 32547-6707
Phone (850) 863-8203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20191119000752 CO Practitioner - Nurse Practitioner 3173955861 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN9439416FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jan 17, 2021 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jan 17, 2021 Accepting new patients
Matthews-Vu Medical Group, P.C. Pediatrics CurrentSince Oct 14, 2019 Accepting new patients
Matthews-Vu Medical Group, P.C. CurrentSince Oct 14, 2019 Accepting new patients
Matthews-Vu Medical Group, P.C. Current Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

104 Pro Rodeo Dr
Ste 100
Colorado Springs, CO 80919
Phone (719) 522-0707

4190 E Woodmen Rd
Ste 100
Colorado Springs, CO 80920
Phone (630) 328-7971

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

9480 Briar Village Pt
Ste 200
Colorado Springs, CO 80920
Phone (719) 278-3627

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2403

Interoperability endpoints

  • Direct secure messaging: rachel.couch.1@21123.direct.athenahealth.com

Organizations & group practices 5

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": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1477034114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476707",
            "telephone_number": "850-863-8203",
            "fax_number": "833-916-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476707",
            "telephone_number": "850-863-8203",
            "fax_number": "850-863-8203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUCH",
        "first_name": "RACHEL",
        "middle_name": "L",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "APRN9439416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.