Individual provider Active NPI

Debbie Koch, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Smith, AR
National Provider Identifier
1649430190
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
A03074 Issued in AR
Practice address
3111 S 70TH St
Fort Smith, AR 72903-5017
Phone
(479) 452-6650
Fax
(479) 452-5847
NPI assigned
Jun 9, 2008
Last updated
Feb 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X A03074 AR Primary
Primary Care Nurse Practitioner 363LP2300X A03074 AR

Addresses

Primary practice location

3111 S 70TH St
Fort Smith, AR 72903-5017

Mailing address

PO Box 11818
Fort Smith, AR 72917-1818
Phone (479) 452-6650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130521000021 AR Practitioner - Nurse Practitioner 8628216223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

3113 S 70TH St
Fort Smith, AR 72903-5017
Phone (479) 478-6664

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A03074ARMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Western Arkansas Counseling & Guidance Center, Inc Current Accepting new patients
Western Arkansas Counseling & Guidance Center CurrentSince Dec 13, 2019 Accepting new patients
The Guidance Center - Whole Health Psychiatric/Mental Health CurrentSince Dec 13, 2019 Accepting new patients
Perspectives Behavioral Health Management, LLC PastSince Feb 2, 2013 Accepting new patients

Locations

3111 S 70th St
Fort Smith, AR 72903

3113 S 70th St
Fort Smith, AR 72903
Phone (479) 478-6664

1200 W Center St
Greenwood, AR 72936
Phone (479) 452-4949

1857 Rice St
Waldron, AR 72958
Phone (479) 637-2468

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1649430190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11818",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729171818",
            "telephone_number": "479-452-6650",
            "fax_number": "479-452-5847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 S 70TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035017",
            "telephone_number": "479-452-6650",
            "fax_number": "479-452-5847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "DEBBIE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "A03074",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AR",
            "license": "A03074",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.