David A. Koch, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG000662 Issued in PA

Practice address

858 E Welsh Rd
Suite 12
Maple Glen, PA 19002-2942

Phone

(215) 542-0460

Fax

(215) 542-9058

NPI assigned

Dec 20, 2006

Last updated

Dec 6, 2007By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1639233075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "858 E WELSH RD",
            "address_2": "SUITE 12",
            "city": "MAPLE GLEN",
            "state": "PA",
            "postal_code": "190022942",
            "telephone_number": "215-542-0460",
            "fax_number": "215-542-9058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "858 E WELSH RD",
            "address_2": "SUITE 12",
            "city": "MAPLE GLEN",
            "state": "PA",
            "postal_code": "190022942",
            "telephone_number": "215-542-0460",
            "fax_number": "215-542-9058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "DAVID",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Maple Glen, PA
• Providers in Maple Glen, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; 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.