Individual provider Active NPI

Lisa M Koch, AU.D.

  • Audiologist
  • Huntington, WV
National Provider Identifier
1609119700
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A0320 Issued in OH
Practice address
601 6TH Ave
Huntington, WV 25701-2103
Phone
(304) 525-7221
NPI assigned
Mar 27, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A0320 OH Primary
Audiologist 231H00000X 0158 KY
Audiologist 231H00000X A0291 WV

Addresses

Primary practice location

601 6TH Ave
Huntington, WV 25701-2103

Mailing address

601 6TH Ave
Huntington, WV 25701-2103
Phone (304) 525-7221

Other identifiers 1

IdentifierTypeStateIssuer
311090322OtherFEIN 311090322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, WV, KY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180227002425 OH Practitioner - Qualified Audiologist 1355602749 Reassigns benefits to 1 organization
I20180529000833 WV Practitioner - Qualified Audiologist 1355602749
I20180808003898 KY Practitioner - Qualified Audiologist 1355602749 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0158KYMDAudiologist
A0320OHMDAudiologist
A0291WVMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Medical, Inc. CurrentSince Jan 16, 2018 Accepting new patients
Jeffrey Leider MD PLLC Audiologist Current Accepting new patients
Mobile Medical Inc Current Accepting new patients
Mobile Medical, Inc. CurrentSince Jan 16, 2018 Accepting new patients
Jeffrey Leider MD PLLC CurrentSince Jun 25, 2018 Accepting new patients
Wsptn, Corp Past Accepting new patients
Mobile Medical, Inc. Past Accepting new patients
H William Mattingly Corporation PastSince Nov 10, 2024 Accepting new patients
De McVey Enterprises Inc Audiologist PastSince Oct 8, 2018 Accepting new patients

Locations

12910 Shelbyville Rd
Ste 300
Louisville, KY 40243
Phone (502) 214-0693

575 White Pond Dr
Ste A
Akron, OH 44320
Phone (330) 835-1629

135 Merchant St
Ste 270
Cincinnati, OH 45246
Phone (513) 771-7483

3255 Levis Commons Blvd
Perrysburg, OH 43551
Phone (419) 874-0393

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1609119700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 6TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257012103",
            "telephone_number": "304-525-7221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 6TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257012103",
            "telephone_number": "304-525-7221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A0320",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "KY",
            "license": "0158",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WV",
            "license": "A0291",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEIN 311090322",
            "identifier": "311090322",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.