NPIMap

Organization Active NPI

Glenn R Koch and Associates Inc

  • Psychiatry Physician
  • Allentown, PA
National Provider Identifier
1700949161
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
PS005286L Issued in PA
Legal business name
GLENN R KOCH AND ASSOCIATES INC
Practice address
961 Marcon Boulevard
Suite 312
Allentown, PA 18109
Phone
(610) 266-0610
Fax
(610) 266-0292
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Glenn Robert Koch, MANPI 1093854309
Title
President Licensed Psychologist
Phone
(610) 266-0610

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X PS005286L PA Primary

Addresses

Primary practice location

961 Marcon Boulevard
Suite 312
Allentown, PA 18109

Mailing address

961 Marcon Boulevard
Suite 312
Allentown, PA 18109
Phone (610) 266-0610

Other identifiers 3

IdentifierTypeStateIssuer
0016509210002MedicaidPA
02817200OtherPACAPITAL BLUE CROSS
GL1454227OtherPAHIGHMARK BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

961 Marcon Blvd
Ste 312
Allentown, PA 18109
Phone (610) 266-0610

Practitioners & affiliated clinicians

Practitioners 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700949161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "961 MARCON BOULEVARD",
            "address_2": "SUITE 312",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18109",
            "telephone_number": "610-266-0610",
            "fax_number": "610-266-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 MARCON BOULEVARD",
            "address_2": "SUITE 312",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18109",
            "telephone_number": "610-266-0610",
            "fax_number": "610-266-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN R KOCH AND ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "610-266-0610",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "PS005286L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016509210002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02817200",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "GL1454227",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.