Organization Active NPI

David a. Koch, O.D., Inc.

  • Optometrist
  • Tipp City, OH
National Provider Identifier
1811166135
Registry record updated Jun 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
55031434 Issued in OH
Legal business name
DAVID A. KOCH, O.D., INC.
Practice address
410 N Hyatt St
Tipp City, OH 45371-1434
Phone
(937) 667-6914
Fax
(937) 667-3744
NPI assigned
Feb 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2013

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

Authorized official

Name
Dr. David Koch, O.D.
Title
Owner
Phone
(937) 667-6914

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 55031434 OH Primary
Eyewear Supplier 332H00000X 55031434 OH

Addresses

Primary practice location

410 N Hyatt St
Tipp City, OH 45371-1434

Mailing address

410 N Hyatt St
Tipp City, OH 45371-1434
Phone (937) 667-6914

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371772800000",
    "number": "1811166135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N HYATT ST",
            "city": "TIPP CITY",
            "state": "OH",
            "postal_code": "453711434",
            "telephone_number": "937-667-6914",
            "fax_number": "937-667-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N HYATT ST",
            "city": "TIPP CITY",
            "state": "OH",
            "postal_code": "453711434",
            "telephone_number": "937-667-6914",
            "fax_number": "937-667-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A. KOCH, O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2013-06-21",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-667-6914",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "55031434",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "OH",
            "license": "55031434",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tipp City, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; 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.