Active NPI
Douglas James Koch, D.C.
- Chiropractor
- Fairfield, CT
National Provider Identifier
1801840574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1000
- Practice address
- 1100 Kings Hwy E
Ste 1C
Fairfield, CT 06825-5400 - Phone
- (203) 576-1993
- Fax
- (203) 333-6497
- NPI assigned
- May 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1000 | CT | Primary |
Addresses
Primary practice location
1100 Kings Hwy E
Ste 1C
Fairfield, CT 06825-5400
Mailing address
1100 Kings Hwy E
Ste 1C
Fairfield, CT 06825-5400
Phone (203) 576-1993
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101115001320 | CT | Practitioner - Chiropractic | 4587859699 | Practice locations: Fairfield, CT |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- New York Chiropractic College, 1991
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1100 Kings Hwy E
Suite 1C
Fairfield, CT 06825-5400
Phone (203) 576-1993
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1000 | CT | MD | Chiropractor |
| 001000 | CT | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492387200000",
"number": "1801840574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 KINGS HWY E",
"address_2": "STE 1C",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068255400",
"telephone_number": "203-576-1993",
"fax_number": "203-333-6497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 KINGS HWY E",
"address_2": "STE 1C",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068255400",
"telephone_number": "203-576-1993",
"fax_number": "203-333-6497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOCH",
"first_name": "DOUGLAS",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2017-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CT",
"license": "1000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.