Koch Chiropractic and Wellness Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3449-12 Issued in WI

Legal business name

KOCH CHIROPRACTIC AND WELLNESS CENTER

Practice address

1990 Godfrey Dr
Waupaca, WI 54981-7908

Phone

(715) 256-9616

Fax

(715) 256-9618

NPI assigned

Aug 16, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gina M KochNPI 1053366203

Title

Dr

Phone

(715) 256-9616

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Tax ID family

Koch Chiropractic and2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Koch Chiropractic and Wellness Center

  • Chiropractor
  • Fremont, WI
  • NPI 1922871334
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Koch Chiropractic and Wellness Center

  • Chiropractor
  • Fremont, WI
  • NPI 1922871334
  NPPES parent name

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gina M. Koch, D.C.

  • Chiropractor
  • Waupaca, WI
  • NPI 1053366203
  Medicare reassignment Care Compare group NPD Authorized official
• Dante Grorich, D.C.

  • Chiropractor
  • Waupaca, WI
  • NPI 1598656696
  Medicare reassignment Care Compare group NPD
• Andrea Benko, D.C.

  • Chiropractor
  • Branford, CT
  • NPI 1174767768

  WI

  Medicare reassignment Care Compare group NPD
• Holly Ann King, D.C

  • Chiropractor
  • Plymouth, MI
  • NPI 1255467213

  WI

  Medicare reassignment Care Compare group NPD
• Maggie A Bezanson, DC

  • Chiropractor
  • Neenah, WI
  • NPI 1407622301
  NPD
• Kenneth E Munson, DC

  • Chiropractor
  • Appleton, WI
  • NPI 1093808537
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1659484574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 GODFREY DR",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549817908",
            "telephone_number": "715-256-9616",
            "fax_number": "715-256-9618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 GODFREY DR",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549817908",
            "telephone_number": "715-256-9616",
            "fax_number": "715-256-9618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOCH CHIROPRACTIC AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2023-11-06",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "715-256-9616",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3449-12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38902900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy T Kenworthy, MD
• Kimberley R Kessenich, PT
• Patty Kile
• Bradley Klein, APNP
• Joy Kobiske, NP
• Gina M. Koch, D.C.
• Michael R. Koch, PT
• Zachary Donald Koepke, DPT
• Jessica Kossel, M.S., CCC-SLP
• Kimberly Marie Kraeger, LCSW

• Chiropractor in Waupaca, WI
• Providers in Waupaca, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.