Active NPI
Marion E Couch, MD
- Otolaryngology Physician
- Indianapolis, IN
National Provider Identifier
1710071980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 01074224A
- Practice address
- 550 University Blvd
RM 3170
Indianapolis, IN 46202-5149 - Phone
- (317) 962-3886
- Fax
- (317) 948-1245
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 200300767 | NC | |
| Otolaryngology Physician | 207Y00000X | 01074224A | IN | Primary |
Addresses
Primary practice location
550 University Blvd
RM 3170
Indianapolis, IN 46202-5149
Mailing address
250 N Shadeland Ave
Suite 130
Indianapolis, IN 46219-4959
Phone (317) 963-0860
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P101641537 | Other | IN | RAILROAD MEDICARE |
| 201233850 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200300767 | NC | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467158400000",
"number": "1710071980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 N SHADELAND AVE",
"address_2": "SUITE 130",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462194959",
"telephone_number": "317-963-0860",
"fax_number": "919-843-5515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 UNIVERSITY BLVD",
"address_2": "RM 3170",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462025149",
"telephone_number": "317-962-3886",
"fax_number": "317-948-1245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COUCH",
"first_name": "MARION",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2016-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NC",
"license": "200300767",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IN",
"license": "01074224A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P101641537",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201233850",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.