Individual provider Active NPI

Gregory Chowanec

  • Psychologist
  • Des Moines, IA
National Provider Identifier
1073196226
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35SI00291800 Issued in NJ
Practice address
3600 30TH St
Des Moines, IA 50310-5753
Phone
(515) 699-5675
NPI assigned
May 4, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35SI00291800 NJ Primary

Addresses

Primary practice location

3600 30TH St
Des Moines, IA 50310-5753

Mailing address

3600 30TH St
Des Moines, IA 50310-5753
Phone (515) 699-5675

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
35SI00291800NJMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1073196226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 30TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503105753",
            "telephone_number": "515-699-5675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 30TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503105753",
            "telephone_number": "515-699-5675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOWANEC",
        "first_name": "GREGORY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00291800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.