DR. JACK L. JR. KOCH (M.D.) – Psychiatry Physician, NPI 1114923737
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
541 PSYCHIATRY in TN
Provider Addresses for DR. JACK L. JR. KOCH (M.D.)
109 Hazel Path Ste 4
Hendersonville, TN 370753888
Phone: (615) 320-1155
Fax: (615) 320-1177
Type: Location
220 Athens Way Ste 104
Nashville, TN 372281351
Phone: (615) 320-1155
Fax: (615) 320-1177
Type: Location
775 Weatherly Dr Ste F
Clarksville, TN 370438915
Phone: (615) 320-1155
Fax: (615) 320-1177
Type: Location
1507 16TH AVE S
NASHVILLE, TN 372122905
Phone: (615) 515-7775
Fax: (615) 523-1483
Type: Location
Belcourt Avenue, Hillsboro Village, Nashville, Davidson County, Tennessee, 37212, United States
NASHVILLE, TN 372123503
Phone: (615) 269-0525
Fax: (615) 269-3596
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 25 Open Payments records for all available years, with a total value of $588.
Total Amount is formed as General ($588) + Research ($0) + Ownership ($0) = $588.
Last reported payment date: 2024-12-21 • Largest payer in this snapshot: Corium, LLC ($300).
Total Amount
$588
General + Research + Ownership
Payments
25
Total payment records
General Amount
$588
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-21
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-05-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240513000637 | I | Psychiatry | TN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 37075)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TN | |
| Clinical Psychologist | TN | |
| Mental Health Counselor | TN | |
| Mental Health Counselor | MA | |
| Nurse Practitioner | TN | |
| - | TN | |
| Clinical Social Worker | FL | |
| Nurse Practitioner | TN | |
| Clinical Social Worker | TN | |
| Nurse Practitioner | TN |
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