S Graham Kosch, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY2354 Issued in FL

Practice address

100 S Ponce de Leon Blvd
Suite 1
St Augustine, FL 32084-4214

Phone

(904) 824-7733

NPI assigned

Jul 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• S Graham Kosch Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490313600000",
    "number": "1528086329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S PONCE DE LEON BLVD",
            "address_2": "SUITE 1",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320844214",
            "telephone_number": "904-824-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S PONCE DE LEON BLVD",
            "address_2": "SUITE 1",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320844214",
            "telephone_number": "904-824-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSCH",
        "first_name": "S",
        "middle_name": "GRAHAM",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2017-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY2354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254757100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "S",
            "last_name": "KOSCH",
            "middle_name": "GRAHAM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jane G Koike, MA
• Kok L. Chong MD PA
• Muhieddine Muhammad Koleilat, PHARMACIST
• John S Koppman, M.D.
• Cornelia Korey, LMT
• Felice I Koscinski, MD
• Jessica Koster, DDS
• Sara L Kouten, LCSW
• Tracy L Kozak, AP
• Dawn E Kpelo

• Psychologist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; 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.