Mark James Koch, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3460 Issued in WI

Practice address

1055 Legion Dr
Elm Grove, WI 53122-2202

Phone

(262) 784-8232

Fax

(262) 784-4139

NPI assigned

Jan 18, 2007

Last updated

Jun 30, 2008By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

ChiropracticAlso: Sports Medicine

Education

Palmer College Chiropractic - Davenport, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mark Koch DC LLC

  • Clinic/Center
  • Elm Grove, WI
  • NPI 1134883861

  Chiropractor

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1699828251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 LEGION DR",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222202",
            "telephone_number": "262-784-8232",
            "fax_number": "262-784-4139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 LEGION DR",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222202",
            "telephone_number": "262-784-8232",
            "fax_number": "262-784-4139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "MARK",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38926800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marilynn Klemstein, NP
• Michaela R Klimko, LPC
• Ariel Namowicz Kloss, LCSW
• Koch Chiropractic LTD.
• Dennis A Koch, D.C.
• Amanda Lynn Kopczyk, O.D.
• Mary Lou Krauithoefer, BSN, RN
• Kendall Kuhary, MS, LPC, NCC
• Samantha Faye Kuspa, RDN, CD, LD
• Lia M Laine

• Chiropractor in Elm Grove, WI
• Providers in Elm Grove, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.