KOCH FAMILY MEDICINE SC
NPI 1376665125
Family Medicine in Morton, IL
About Koch Family Medicine Sc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KOCH FAMILY MEDICINE SC (NPI 1376665125) is a healthcare organization registered as a family medicine in Morton, Illinois and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through August 31, 2028 and lists Stanley Koch, Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Koch Family Medicine Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
11Medicare enrollment records show 11 clinicians reassign Medicare billing to Koch Family Medicine Sc, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 8 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 3
Clinicians, nearest first (11)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 14D0677046
Koch Family Medicine · Morton, ILFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Koch Family Medicine Sc's NPI number?
The NPI number for Koch Family Medicine Sc is 1376665125. It was assigned to this organization in the NPPES registry on April 4, 2007.
Where is Koch Family Medicine Sc located?
Koch Family Medicine Sc is located at 411 Maxine Dr, Morton, IL 61550. The listed phone number is (309) 263-2411.
What is Koch Family Medicine Sc's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Koch Family Medicine Sc enrolled in Medicare?
Yes. Koch Family Medicine Sc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Koch Family Medicine Sc?
According to the CMS Revalidation Reassignment List (October 2026 release), 11 clinicians in 3 Medicare specialties reassign their Medicare billing to Koch Family Medicine Sc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Physical Therapist in Private Practice (5), Family Practice (3) and Nurse Practitioner (3). Of these, 4 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Koch Family Medicine Sc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 14D0677046) is associated with this NPI, valid through August 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Koch Family Medicine Sc was last updated on October 20, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Koch Family Medicine Sc · NPI 1376665125
Family Medicine organization in Morton, Illinois. Organization record, active in the CMS NPPES registry since April 4, 2007.
## Identity
- **NPI:** 1376665125 (Entity type: Organization)
- **Enumerated:** April 4, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Stanley Koch, PHYSICIAN
## Practice location
- **Address:** 411 MAXINE DR, Morton, IL 61550-2495
- **Phone:** (309) 263-2411
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 11 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Physical Therapist in Private Practice (5), Family Practice (3), Nurse Practitioner (3); 4 practice at this address and 8 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 20, 2010
- **Other identifiers:** Medicare ID-Type Unspecified 211327 (IL); Other 1467436436 (IL); Medicaid 036060959 (IL); and 1 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1376665125) · Data from the CMS NPPES public registry.