Eric S Ko, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

3100 Channing Way
Idaho Falls, ID 83404-7533

Phone

(208) 529-6111

NPI assigned

Mar 22, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Interoperability endpoints

• Direct secure messaging: eric.ko.1@16437.direct.athenahealth.com

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

{
    "created_epoch": "1742601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742601600000",
    "number": "1629879804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 S 500 E APT 73",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841061262",
            "telephone_number": "435-236-0917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047533",
            "telephone_number": "208-529-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "ERIC",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-22",
        "last_updated": "2025-03-22",
        "certification_date": "2025-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Lee Shepherd Klosterman, LCPC
• Tristian J Knight, LMSW
• Lynda Knouse
• Kenya Eve Knudsen
• Ronda Sue Knudsen, LPC
• Kelsey Kobzi, PHARMD
• Lee Anne Koelzer, BA, CPI, CPSS
• Lucas John Koenen, DO
• Todd Edward Koerner, CRNA
• Kim G Kohler, RPH

• Student in an Organized Health Care Education/Training Program in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Student in an Organized Health Care Education/Training Program in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.