Active NPI
Erin Renee Koch, ATC, EMT
- Athletic Trainer
- Peru, NE
National Provider Identifier
1790175883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 664
- Practice address
- 600 Hoyt St
Peru, NE 68421-3073 - Phone
- (785) 294-1534
- NPI assigned
- Jan 28, 2015
- Last updated
- Jan 28, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 664 | NE | Primary |
Addresses
Primary practice location
600 Hoyt St
Peru, NE 68421-3073
Mailing address
PO Box 10
600 Hoyt St
Peru, NE 68421-0010
Phone (785) 294-1534
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)
- Not enrolled
- Credentials
- Emergency Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 664 | NE | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422403200000",
"number": "1790175883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10",
"address_2": "600 HOYT ST",
"city": "PERU",
"state": "NE",
"postal_code": "684210010",
"telephone_number": "785-294-1534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 HOYT ST",
"city": "PERU",
"state": "NE",
"postal_code": "684213073",
"telephone_number": "785-294-1534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOCH",
"first_name": "ERIN",
"middle_name": "RENEE",
"credential": "ATC, EMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-28",
"last_updated": "2015-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NE",
"license": "664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peru, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.