Alisha Renae Koch, ARNP
Individual provider Active NPI Family Nurse Practitioner · Lyons, KS
NPI 1710279872 · NPPES record last updated May 9, 2011
Key facts
- NPI
- 1710279872
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 1496664061 (KS)
- Practice address
- 619 S Clark Ave
Lyons, KS 67554-3003 - Phone
- (620) 257-7150
- NPI assigned
- May 9, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hospital District No 1 of Rice Co
Practice addresses (Care Compare)
1221 W Noble St
Lyons Medical Center
Lyons, KS 67554-3026
Phone (620) 257-5124
239 N Broadway Ave
Sterling Med Center
Sterling, KS 67579-1916
Phone (620) 278-2123
Hospital & facility affiliations
- Hospital District #1 of Rice County
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120216000399 | KS | Practitioner - Nurse Practitioner | 7618135963 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1496664061 | KS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital District No 1 of Rice Co | Current |
Accepting new patients | |
| Hospital District No 1 of Rice Co | Current |
Accepting new patients | |
| Medical Center, P.a. | Past | Accepting new patients |
Locations
619 S Clark Ave
Lyons, KS 67554
Phone (620) 257-5173
1221 W Noble St
Lyons, KS 67554
Phone (620) 257-5124
239 N Broadway Ave
Sterling, KS 67579
Phone (620) 278-2123
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1496664061 | KS | Yes |
Addresses
Primary practice location
619 S Clark Ave
Lyons, KS 67554-3003
Mailing address
619 S Clark Ave
P.O. Box 828
Lyons, KS 67554-3003
Phone (620) 257-7150
Other providers in Lyons, KS
- Hospital District No 1 of Rice Co
- Hutchinson Clinic, P.a., Inc.
- Vicki Johnston
- Amber Kaspar
- Roger Allen Klein
- David Leyroy Liska
- LJ Norman DC LLC
- Ludwig Family Chiropractic LLC
- Robert Brian Ludwig
- Lyon Pharmacy Inc
All providers in Lyons, KS · Family Nurse Practitioner in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.