KENNETH M KOCH (NPI# 1437165487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437165487 |
| Entity Type | Individual |
| Full Name | KENNETH M KOCH |
| Credential | MD |
| Practice Address |
1050 Larpenteur Ave W Saint Paul MN 55113-6556 |
| Mailing Address |
2025 Sloan Pl Suite 35 Saint Paul MN 55117-2007 |
| Practice Telephone | 6514872831 |
| Practice Fax Number | 6514871705 |
| Mailing Telephone | 6517721572 |
| Mailing Fax Number | 6517721889 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2011-10-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 32669 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 984808800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982033429 | Kenneth Troy Koch | Pharmacist | 216 N Taylor Ave, Oak Park, IL 60302-2526 | 2013-11-05 |
| 1386621050 | Kenneth Robert Koch | Chiropractor | 3449 E Plankinton Ave, Cudahy, WI 53110-1413 | 2005-12-23 |
| 1689121949 | Kenneth James Koch | Rehabilitation Practitioner | 3680 N Rancho Dr, Las Vegas, NV 89130-3180 | 2016-09-04 |
| 1649466053 | Kenneth G. Koch | Chiropractor | 9484 Black Mountain Rd, Ste I, San Diego, CA 92126-4520 | 2007-09-19 |
| 1871665182 | Kenneth Lyle Koch | Optometrist | 124 E Rowan Ave, Suite 101, Spokane, WA 99207-1214 | 2006-11-14 |
| 1588649925 | Kenneth Koch | Internal Medicine | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2005-12-08 |
| Street Address |
1050 LARPENTEUR AVE W |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55113-6556 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891759239 | Gloria M Garcia | Family Medicine | 1050 Larpenteur Ave W, Saint Paul, MN 55113-6556 | 2006-04-13 |
| 1720432461 | Samantha Min Min Ngaw | Family Medicine | 1050 Larpenteur Ave W, Saint Paul, MN 55113-6556 | 2016-04-19 |
| 1447640495 | Kelly R Linnihan | Physician Assistant | 1050 Larpenteur Ave W, Saint Paul, MN 55113-6556 | 2015-01-29 |
| 1043642135 | St Paul Family Dentistry | Dentist | 1050 Larpenteur Ave W, Saint Paul, MN 55113-6556 | 2013-07-31 |
| 1427332758 | Todd Anthony Thayer | Dentist | 1050 Larpenteur Ave W, Saint Paul, MN 55113-6556 | 2011-10-05 |
| 1033437942 | Grete Feist Thomsen | Physician Assistant | 1050 Larpenteur Ave W, Saint Paul, MN 55113-6556 | 2010-05-17 |
| 1629258355 | Family Healthservices Minnesota, P.a. | Family Medicine | 1050 Larpenteur Ave W, Saint Paul, MN 55113-6556 | 2007-11-09 |
| 1215129390 | Joseph M Opack | Dentist | 1050 Larpenteur Ave W, Saint Paul, MN 55113-6556 | 2007-08-13 |
| 1780801894 | Minnhealth Family Physicians, P.a. | Family Medicine | 1050 Larpenteur Ave W, Saint Paul, MN 55113-6556 | 2007-04-19 |
| 1417098278 | Family Healthservices Minnesota, P.a | Non-Pharmacy Dispensing Site | 1050 Larpenteur Ave W, Saint Paul, MN 55113-6556 | 2007-02-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396384376 | Zachary Mattson | Physician Assistant | Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 | 2019-12-23 |
| 1467010330 | Ahmed Issa | Student in an Organized Health Care Education/Training Program | 1550 Larpenteur Ave W, Apt 235, St Paul, MN 55113 | 2019-06-05 |
| 1821653833 | Suite Living Senior Care of Little Canada | Assisted Living Facility | 2740 Rice Street, Little Canada, MN 55113 | 2019-05-06 |
| 1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
| 1588138473 | Applewood Home Health Care, LLC | Home Health | 2021 E Hennepin Avenue # 402-1, Minneapolis, MN 55113 | 2019-01-14 |
| 1699251520 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2685 Patton Rd, Roseville, MN 55113 | 2018-07-13 |
| 1083104145 | Suite Living Senior Care of Roseville | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55113 | 2018-05-15 |
| 1477055796 | Sunrise Residential Services LLC | Home Health | 216 Maple Ln, Roseville, MN 55113 | 2018-03-02 |
| 1194223024 | Alissa Hoff | Specialist | 1595 Mn 36 - 584 10 Rosedale Center, Roseville, MN 55113 | 2018-01-25 |
| 1841705118 | Kingsland Care Services Incorporated | Case Management | 2301 Rice Street, Suite 101, Roseville, MN 55113 | 2017-12-08 |
| Find all providers in zip 55113 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457889420 | Thanh Phung | Family Medicine | 2155 Ford Pkwy Ste A, Saint Paul, MN 55116-2799 | 2017-06-02 |
| 1518338268 | Northstar Professional Services | Family Medicine | 924 Rice St, Saint Paul, MN 55117-4987 | 2015-10-07 |
| 1386064111 | Laura Giegler | Family Medicine | 1983 Sloan Pl Ste 1, Saint Paul, MN 55117 | 2014-04-19 |
| 1306287719 | John Gordon Faughnan | Family Medicine | 1660 Stanford Ave, Saint Paul, MN 55105-2038 | 2013-07-13 |
| 1194041277 | Mark William Eaton | Family Medicine | 333 Smith Ave N # Ms 60202, Saint Paul, MN 55102-2344 | 2010-04-14 |
| 1326277815 | Branden James Pfefferkorn | Family Medicine | 2004 Ford Pkwy # Ms 35300a, Saint Paul, MN 55116-1931 | 2009-07-07 |
| 1780812651 | James Edward Hougas IIi | Family Medicine | Ump Phalen Village Clinic, 1414 Maryland Ave E, Saint Paul, MN 55106 | 2009-06-30 |
| 1871748509 | Deborah Lee Wexler | Family Medicine | 1573 Selby Ave, Suite 234, Saint Paul, MN 55104-6293 | 2008-11-21 |
| 1124206677 | Family Healthservices Minnesota, P.a. | Family Medicine | 2025 Sloan Pl, Suite 35, Saint Paul, MN 55117-2007 | 2008-02-07 |
| 1174703805 | Family Healthservices Minnesota, P.a. Dba Entira Family Clinics | Family Medicine | 1385 Phalen Boulevard, Saint Paul, MN 55106 | 2007-11-09 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55113 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.