NPIMap

Organization Active NPI

Koca Chiropractic Clinic

  • Chiropractor
  • Omaha, NE
National Provider Identifier
1609025592
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
KOCA CHIROPRACTIC CLINIC
Practice address
2085 N 120TH St
Suite D6
Omaha, NE 68164-3479
Phone
(402) 496-4570
Fax
(402) 496-8972
NPI assigned
Sep 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

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

Authorized official

Name
Dr. Lyle E Koca, D.C.NPI 1023176773
Title
Owner
Phone
(402) 496-4570

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

2085 N 120TH St
Suite D6
Omaha, NE 68164-3479

Mailing address

2085 N 120TH St
Suite D6
Omaha, NE 68164-3479
Phone (402) 496-4570

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080923000635 NE Part B Supplier - Clinic/Group Practice 5799852356 Receives reassigned benefits from 2 practitioners
Practice locations: Omaha, NE

National Provider Directory

National Provider Directory

Locations

2085 N 120th St
Ste D6
Omaha, NE 68164
Phone (402) 496-4570

11420 Blondo St
Ste 102
Omaha, NE 68164
Phone (402) 496-4570

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1609025592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 N 120TH ST",
            "address_2": "SUITE D6",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681643479",
            "telephone_number": "402-496-4570",
            "fax_number": "402-496-8972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 N 120TH ST",
            "address_2": "SUITE D6",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681643479",
            "telephone_number": "402-496-4570",
            "fax_number": "402-496-8972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOCA CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-16",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "KOCA",
        "authorized_official_first_name": "LYLE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-496-4570",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.