Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelsey Elyce Koch, MD

Individual provider Surgery Physician · NPI 1619327848

Kelsey Elyce Koch, MD is a Thoracic Surgery in Jackson, Mississippi. Graduated from Stanford University School of Medicine in 2016, 10 years ago. Practices with St Dominic Medical Associates LLC, a 127-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Iowa and Mississippi.

Years since qualifying
10
Trained at
Stanford University School of Medicine
Licensed in
IA, MS
In the registry since
2016
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

971 Lakeland Dr Ste 220
Jackson, MS 39216-4643
Phone: (601) 200-2780
Fax: (601) 200-2788
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 501 Marshall St Ste 104, Jackson, MS 39202-1663 — (601) 969-6404
  • 1225 N State St, Jackson, MS 39202-2064 — (601) 968-5003
  • 2500 N State St, Jackson, MS 39216-4500 — (601) 984-5170

Specialties & licences

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician (primary) Taxonomy 208G00000X · Licence 35449 (MS)
Surgery Physician Taxonomy 208600000X · Licence R-10660 (IA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1619327848
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 19, 2016
Last updated in NPPESJune 6, 2026
Certification dateJune 6, 2026
Mailing address2500 N State St, Jackson, MS 39216-4500

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyTHORACIC SURGERY
Also practisesCARDIOVASCULAR DISEASE (CARDIOLOGY)
Medical schoolSTANFORD UNIVERSITY SCHOOL OF MEDICINE
Graduated 2016 (10 years in practice)
Group practice St. Dominic Medical Associates Llc — 127 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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