Alice Koech, A-GNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

10000878 Issued in OR

Practice address

1700 NW Garden Valley Blvd Ste 201
Roseburg, OR 97471-1636

Phone

(541) 464-0788

NPI assigned

Jul 6, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, WA, CO3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intermountain Medical Group Grand Junction, LLCGroup PAC ID 3779707856, 297 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health St. Mary'S Regional Hospital Hospital, Grand Junction, CO, CCN 060023
• Delta County Memorial Hospital Hospital, Delta, CO, CCN 060071
• Montrose Regional Health Hospital, Montrose, CO, CCN 060006

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Intermountain Medical Group Grand Junction, LLC

  • Orthopaedic Surgery Physician
  • Grand Junction, CO
  • NPI 1356765556
  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  WA

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1306192455
  NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD
• Intermountain Medical Group Grand Junction, LLC

  • Durable Medical Equipment & Medical Supplies
  • Grand Junction, CO
  • NPI 1609737618
  NPD
• Intermountain Medical Group Grand Junction, LLC

  • Rheumatology Physician
  • Grand Junction, CO
  • NPI 1942929641
  NPD
• St Mary'S Hospital and Medical Center, Inc

  • Hematology & Oncology Physician
  • Grand Junction, CO
  • NPI 1275714081
  NPD (past)
• St Mary'S Hospital and Medical Center, Inc

  • General Acute Care Hospital
  • Grand Junction, CO
  • NPI 1619742806
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Delta County Memorial Hospital

  • Rural Acute Care Hospital
  • Delta, CO
  • NPI 1417935446
  Care Compare affiliation
• Montrose Memorial Hospital, Inc

  • General Acute Care Hospital
  • Montrose, CO
  • NPI 1205822186
  Care Compare affiliation
• St Mary'S Hospital and Medical Center, Inc

  • Ambulance
  • Grand Junction, CO
  • NPI 1164060877

  Hospital

  Care Compare affiliation
• St Mary'S Hospital and Medical Center, Inc

  • General Acute Care Hospital
  • Grand Junction, CO
  • NPI 1619742806
  Care Compare affiliation
• St Mary'S Hospital and Medical Center, Inc

  • General Acute Care Hospital
  • Grand Junction, CO
  • NPI 1821647801
  Care Compare affiliation
• St. Mary'S Hospital and Medical Center, Inc.

  • General Acute Care Hospital
  • Grand Junction, CO
  • NPI 1699716027
  Care Compare affiliation

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1669105656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 W YOUNG ST",
            "city": "ELMA",
            "state": "WA",
            "postal_code": "985419090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 NW GARDEN VALLEY BLVD STE 201",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711636",
            "telephone_number": "541-464-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOECH",
        "first_name": "ALICE",
        "credential": "A-GNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-06",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP61327739",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP61327739",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WA",
            "license": "AP61327739",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "10000878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristie M Knight
• Memory Knight
• Katelynn Knous, RDH
• Gregory J Knutson
• Aimee Kodiaq, FNP
• Casey Kohl, LCSW
• Brock Kolander
• Penny L Kollen, RN
• Caitlin Courtney Konicek, DDS
• Jennifer M Kormendi, RDN

• Nurse Practitioner in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.