Active NPI
Bryan Fredrick Koch, ATC
- Athletic Trainer
- Birmingham, AL
National Provider Identifier
1982967006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 378
- Practice address
- 608 13TH St S
WB 104
Birmingham, AL 35294 - Phone
- (205) 934-7588
- Fax
- (205) 975-9258
- NPI assigned
- Jun 22, 2012
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 378 | AL | Primary |
Addresses
Primary practice location
608 13TH St S
WB 104
Birmingham, AL 35294
Mailing address
608 13TH St S
WB 104
Birmingham, AL 35294
Phone (205) 934-7588
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 378 | AL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340323200000",
"number": "1982967006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "608 13TH ST S",
"address_2": "WB 104",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "35294",
"telephone_number": "205-934-7588",
"fax_number": "205-975-9258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "608 13TH ST S",
"address_2": "WB 104",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "35294",
"telephone_number": "205-934-7588",
"fax_number": "205-975-9258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOCH",
"first_name": "BRYAN",
"middle_name": "FREDRICK",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-22",
"last_updated": "2012-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AL",
"license": "378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.