Physician Compare National (NPI:1679130363)

HEALTHCARE PROVIDER: KATHERINE ELIZABETH KOCH DPT

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1679130363
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0547596033
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190722000906
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KOCH
	Individual professional last name
Provider First Name	KATHERINE
	Individual professional first name
Provider Middle Name	ELIZABETH
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2019
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL THERAPY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	BLUE SKY PHYSICAL THERAPY, PC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	3971668583
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	6
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	155 S MADISON ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 303
	Group Practice or individual's line 2 address
City	DENVER
	Group Practice or individual's city
State	CO
	Group Practice or individual's state
Zip Code	802093014
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3033881537
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y