Nicholas Kouchoukos, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

28052 Issued in MO

Practice address

3023 N Ballas Rd Ste 150D
Saint Louis, MO 63131-2319

Phone

(314) 996-5287

Fax

(314) 432-6068

NPI assigned

Aug 31, 2006

Last updated

Mar 11, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1972614576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 N BALLAS RD STE 150D",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312319",
            "telephone_number": "314-996-5287",
            "fax_number": "314-432-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 N BALLAS RD STE 150D",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312319",
            "telephone_number": "314-996-5287",
            "fax_number": "314-432-6068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUCHOUKOS",
        "first_name": "NICHOLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MO",
            "license": "28052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202103727",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kunal D Kotkar, MD
• Lawrence M Kotner, MD
• Brandy Kotzamanis
• Paul Thomas Kotzbauer, MD
• Adou Kouame, MD
• Shalen Kouk, MD
• Carole C Kounga, MD
• Stephanie Kovac
• Maghy Anne Kovach, CRNA
• Danielle Barbara Kovacic, PNP

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.