Max W Koch

Primary specialty

Orthotic FitterTaxonomy code 225000000X

Practice address

400 Industrial Blvd
Ste 108
Mansfield, TX 76063-2202

Phone

(817) 453-2800

Fax

(866) 409-0273

NPI assigned

Nov 30, 2007

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)

Not enrolled

Practice roles

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.

• Max W Koch

  dba Med Link Metro

  • Durable Medical Equipment & Medical Supplies
  • Mansfield, TX
  • NPI 1093751687
  NPD (past) Authorized official

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1649452707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 BISCAYNE DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633235",
            "telephone_number": "817-909-6293",
            "fax_number": "866-409-0273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 INDUSTRIAL BLVD",
            "address_2": "STE 108",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760632202",
            "telephone_number": "817-453-2800",
            "fax_number": "866-409-0273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "MAX",
        "middle_name": "W",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-30",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthotic Fitter in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Orthotic Fitter in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.