Individual provider Active NPI

William R Kock Jr.

  • Critical Care Medicine Registered Nurse
  • Cincinnati, OH
National Provider Identifier
1518667013
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
379272 Issued in OH
Practice address
3200 Vine St
Cincinnati, OH 45220-2213
Phone
(513) 861-3100
NPI assigned
Mar 6, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered NurseGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 163WC0200X 379272 OH Primary

Addresses

Primary practice location

3200 Vine St
Cincinnati, OH 45220-2213

Mailing address

3234 Blue Rock Rd
Cincinnati, OH 45239-6100
Phone (513) 404-5513

Other identifiers 1

IdentifierTypeStateIssuer
379272MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
379272OHMDCritical Care Medicine Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1518667013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3234 BLUE ROCK RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452396100",
            "telephone_number": "513-404-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 VINE ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452202213",
            "telephone_number": "513-861-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCK",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "OH",
            "license": "379272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379272",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.