DR. GARY KOCH (NPI# 1861845208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861845208 |
| Entity Type | Individual |
| Full Name | DR. GARY KOCH |
| Credential | PH.D. |
| Practice Address |
500 Market St Ste 204b Beaver PA 15009 |
| Mailing Address |
500 Market St Ste 204b Beaver PA 15009-2998 |
| Practice Telephone | 7247286670 |
| Practice Fax Number | 7247285570 |
| Mailing Telephone | 7247286670 |
| Mailing Fax Number | 7247285570 |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2018-07-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PS018065 | PA | Behavioral Health & Social Service Providers |
| N | 103TS0200X |
Psychologist Specialization: School |
PS018065 | PA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1032369400002 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 101 Serendipity Dr, Coraopolis, PA 151081153 | 4129806532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750446704 | Gary C Koch | Chiropractor | 11959 Perry Hwy, Wexford, PA 15090-8602 | 2006-12-27 |
| 1265478929 | Gary A. Koch | Family Medicine | 5216 Point Fosdick Dr Ste 102, Gig Harbor, WA 98335-0037 | 2006-06-21 |
| Street Address |
500 MARKET ST STE 204B |
| City | BEAVER |
| State | PA |
| Zip Code | 15009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376029330 | Gina Marie Gordon | Counselor | 500 Market St Ste 204b, Beaver, PA 15009-2998 | 2018-07-12 |
| 1831699636 | Rich Collins | Counselor | 500 Market St Ste 204b, Beaver, PA 15009-2998 | 2018-02-19 |
| 1023516713 | Jessica Ann Wright | Social Worker | 500 Market St Ste 204b, Beaver, PA 15009-2998 | 2018-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548734494 | Renee Thomas | Registered Nurse | 659 3rd Street, Upper Suite, Beaver, PA 15009 | 2019-01-14 |
| 1275048654 | Dominic J. Deluigi Phd LLC | Psychologist | 500 Market St., Sutei 204b, Beaver, PA 15009 | 2017-12-07 |
| 1326367616 | Merakey Pennsylvania | Community/Behavioral Health | 148 Theodore Drive, Chippewa, PA 15009 | 2010-05-26 |
| 1912237215 | Sandra L. Mckeel | Counselor | 697 State Street, Vanport, PA 15009 | 2010-01-08 |
| 1790019438 | Tri-state Medical Group, Inc. | Physical Medicine & Rehabilitation | 1030 Beaner Hollow Road, Beaver Medical Commons, Beaver, PA 15009 | 2009-09-29 |
| 1700040730 | Marie R Brauch | Counselor | 697 State St, #5, Beaver, PA 15009 | 2008-07-18 |
| 1932376696 | Justin Dosch | Emergency Medicine | 1000 Dutch Run Rd, Beaver, PA 15009 | 2008-05-13 |
| 1023280492 | Paul Michael Kuzma Jr Md | Ophthalmology | 628 Market Street, Bridgewater, PA 15009 | 2008-03-26 |
| 1881877868 | Jaime Michelle Kinkead | Social Worker | 160 Third Street, Beaver, PA 15009 | 2007-12-12 |
| 1588851018 | Barry Brevik Orthopedic Rehabilitation | Physical Medicine & Rehabilitation | 363 Third Street, Beaver, PA 15009 | 2007-09-28 |
| Find all providers in zip 15009 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275048654 | Dominic J. Deluigi Phd LLC | Psychologist | 500 Market St., Sutei 204b, Beaver, PA 15009 | 2017-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629615810 | Ganim Psychology and Behavioral Health, Pllc | Psychologist | 80 West Welsh Pool Road, Suite 204 South, Exton, PA 19341-1233 | 2019-12-06 |
| 1164067450 | Whitney Guthrie | Psychologist | 2716 South St Ofc 5241, Philadelphia, PA 19146-2305 | 2019-11-11 |
| 1205470176 | Thomas Anderson Smith | Psychologist | 491 Allendale Rd Ste 320, King of Prussia, PA 19406-1432 | 2019-11-04 |
| 1841849460 | Colleen Mary Harker | Psychologist | 1518 Walnut St Ste 1506, Philadelphia, PA 19102-3408 | 2019-09-06 |
| 1548815814 | Estee Hausman | Psychologist | 337 Moore Bldg, State College, PA 16802-3103 | 2019-08-05 |
| 1326512005 | Lydia Brill | Psychologist | 480 Pierce St Ste 109, Kingston, PA 18704-5512 | 2019-01-16 |
| 1689151318 | Stacey Linn Brookens | Psychologist | 77 N 3rd St Ste 201, Chambersburg, PA 17201-1812 | 2018-07-25 |
| 1144710039 | Pamela Marie Cole | Psychologist | 3rd Floor, Moore Building, Penn State University, University Park, PA 16802 | 2018-05-16 |
| 1326536749 | Rebecca Kanine | Psychologist | 2716 South St Fl 8, Philadelphia, PA 19146-2305 | 2018-05-01 |
| 1346768074 | Johanna Rich Tesman | Psychologist | 1200 Walnut Bottom Rd Ste 311, Carlisle, PA 17015-7766 | 2017-09-01 |
| Find all providers with the same taxonomy | ||||
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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.