Active NPI
Nicholas Burke Koch, MD
- Urology Physician
- Raleigh, NC
National Provider Identifier
1891374260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 2026-05086
- Practice address
- 3100 Blue Ridge Rd Ste 301
Raleigh, NC 27612-8036 - Phone
- (919) 784-2930
- Fax
- (919) 784-2929
- NPI assigned
- Apr 5, 2021
- Last updated
- Sep 14, 2026
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | 2026-05086 | NC | Primary |
Addresses
Primary practice location
3100 Blue Ridge Rd Ste 301
Raleigh, NC 27612-8036
Mailing address
1000 Blythe Blvd
Charlotte, NC 28203-5871
Phone (704) 446-9243
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 303189 | NC | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789344000000",
"number": "1891374260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 BLYTHE BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035871",
"telephone_number": "704-446-9243",
"fax_number": "704-446-9120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 BLUE RIDGE RD STE 301",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276128036",
"telephone_number": "919-784-2930",
"fax_number": "919-784-2929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOCH",
"first_name": "NICHOLAS",
"middle_name": "BURKE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-05",
"last_updated": "2026-09-14",
"certification_date": "2026-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NC",
"license": "2026-05086",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.