DR. JASON JOHN KOCH (NPI# 1902919798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902919798 |
| Entity Type | Individual |
| Full Name | DR. JASON JOHN KOCH |
| Credential | MD |
| Practice Address |
3955 Parklawn Ave Ste 120 Edina MN 55435-5655 |
| Practice Telephone | 9528311944 |
| Practice Fax Number | 9522786947 |
| Mailing Telephone | 9528311944 |
| Mailing Fax Number | 9522786947 |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 41959 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BC/BS | 057R8KO | 01 |
| MN | PREFERRED ONE | FP9021027171 | 01 |
| MN | MEDICA | 1201269 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437579323 | Jason T. Koch | Family Medicine | 280 Main St Ste 210, Nashua, NH 03060 | 2014-04-18 |
| 1649459264 | Jason Mantle Koch | Dentist | 95 Raywick Rd, St Mary, KY 40063-8800 | 2007-10-31 |
| 1922183938 | Jason Robert Koch | Chiropractor | 4600 Walnut St, Mckeesport, PA 15132-6233 | 2006-10-26 |
| 1245752245 | Jason K Koch | Adult Companion | 847 Ne 19th Ave, Portland, OR 97232-2684 | 2017-07-11 |
| 1922401066 | Jason R Koch | Physician Assistant | 7220 Mount Rushmore Rd, Rapid City, SD 57702 | 2014-10-03 |
| Street Address |
3955 PARKLAWN AVE STE 120 |
| City | EDINA |
| State | MN |
| Zip Code | 55435-5655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396748307 | Lifescan Minnesota LLC | Clinic/Center | 3955 Parklawn Ave, Ste 110, Edina, MN 55435-5657 | 2005-05-23 |
| 1033506357 | Lauren Bray | Student in an Organized Health Care Education/Training Program | 3955 Parklawn Ave, Edina, MN 55435-5655 | 2015-04-24 |
| 1073831269 | Shannon Nicole Bailey Nolan | Pediatrics | 3955 Parklawn Ave, Suite 200, Edina, MN 55435-5655 | 2010-05-12 |
| 1790002889 | Megan Landry Stalpes | Pediatrics | 3955 Parklawn Ave, Edina, MN 55435-5655 | 2010-04-28 |
| 1528291168 | Karen E Tamte | Pediatrics | 3955 Parklawn Ave, Suite 120, Edina, MN 55435-5655 | 2009-08-31 |
| 1134354608 | Elsa Victoria Fiebiger | Pediatrics | 3955 Parklawn Ave, Suite 200, Edina, MN 55435-5655 | 2009-05-27 |
| 1356576938 | Megan Colleen Iliev | Pediatrics | 3955 Parklawn Ave, Suite 200, Edina, MN 55435-5655 | 2009-05-26 |
| 1649443920 | Amy Lynne Wudel | Pediatrics | 3955 Parklawn Ave, Suite 200, Edina, MN 55435 | 2008-04-08 |
| 1992975494 | Krista Rose Hagen | Pediatrics | 3955 Parklawn Ave, Suite 120, Edina, MN 55435-5655 | 2008-03-11 |
| 1245305895 | Southdale Pediatric Associates, Ltd | Clinic/Center | 3955 Parklawn Ave, Ste 120, Edina, MN 55435-5655 | 2006-11-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433416 | Evy Christine Claussen | Social Worker | 6363 France Ave. S., Edina, MN 55435 | 2020-09-30 |
| 1508496621 | Samantha Jean Mcgough Lamere | Physician Assistant | 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435 | 2020-01-16 |
| 1659920460 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3408 Galleria, Edina, MN 55435 | 2019-09-05 |
| 1730651639 | Taylor Lee Kehoe | Physician Assistant | 7400 France Ave., Suite #100, Edina, MN 55435 | 2018-12-18 |
| 1538666326 | Amanda Deangelo | Physical Therapist | 6401 Southdale Hospital, Ll3g, Edina, MN 55435 | 2018-04-09 |
| 1982107876 | Julia Seliber | Dental Hygienist | 7600 France Ave.s. Suite 1100, Edina, MN 55435 | 2018-03-16 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1730605528 | Edina Medical Supplies | Durable Medical Equipment & Medical Supplies | 7455 France Ave., #614 S, Edina, MN 55435 | 2017-08-14 |
| 1033565510 | Minnesota Disc Replacement and Spine Restoration Center | Clinic/Center | 4444 76 St, #700, Edina, MN 55435 | 2016-05-13 |
| 1306206321 | Barb Ryan | Mechanotherapist | 7550 France Avenue S, #220, Edina, MN 55435 | 2016-03-03 |
| Find all providers in zip 55435 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134564958 | Megan Eileen Fischer | Pediatrics | 6545 France Avenue S #400, Metropolitan Pediatric Specialists, Edina, MN 55435 | 2013-05-07 |
| 1619119096 | James G Cardle | Pediatrics | 4720 Phlox Ln, Edina, MN 55435-4011 | 2009-03-31 |
| 1144487695 | Mitchell Jay Einzig | Pediatrics | 7735 Pondwood Dr, Edina, MN 55439-2764 | 2008-05-21 |
| 1033384599 | Deneen Vojta | Pediatrics | 5201 Kellogg Ave, Edina, MN 55424-1304 | 2008-04-25 |
| 1750551727 | Melissa Anne Hersey | Pediatrics | 3955 Parklawn Ave Ste 120, Edina, MN 55435-5660 | 2008-03-06 |
| 1477525996 | Angela Dawn Siwek | Pediatrics | 3955 Parklawn Avenue, Suite 120, Edina, MN 55435 | 2006-02-07 |
| 1528063500 | Gitte Wengler | Pediatrics | 3250 W 66th St, Ste 210, Edina, MN 55435-2526 | 2005-06-16 |
| 1316940778 | Vicki Jean Thomson | Pediatrics | 7380 France Ave S, Edina, MN 55435-4535 | 2005-05-31 |
| 1316473143 | Holly Belgum | Pediatrics | 6517 Drew Ave S, Edina, MN 55435-2103 | 2017-05-11 |
| 1659726941 | Stephen Rudy Knier | Pediatrics | 3955 Parklawn Ave Ste 120, Edina, MN 55435-5660 | 2016-04-25 |
| Find all providers in EDINA | ||||
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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.