Individual provider Active NPI

Jolene Marie Givant, P.A.-C

  • Physician Assistant
  • Des Moines, IA
National Provider Identifier
1073505780
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
01164 Issued in IA
Practice address
3200 Grand Ave
Des Moines, IA 50312-4104
Phone
(515) 271-1710
Fax
(515) 271-1575
NPI assigned
Aug 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 01164 IA Primary

Addresses

Primary practice location

3200 Grand Ave
Des Moines, IA 50312-4104

Mailing address

3200 Grand Ave
Des Moines, IA 50312-4104
Phone (515) 271-1710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100129000493 IA Practitioner - Physician Assistant 7012050024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1555 Hull Ave
Des Moines, IA 50316-1341
Phone (515) 262-5639

3200 Grand Ave
Des Moines, IA 50312-4104

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
01164IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Des Moines University Osteopathic Medical Center Physician Assistant CurrentSince Aug 1, 2000 Accepting new patients
Diagnostic & Critical Care Medicine Past Accepting new patients
Boone County Hospital Past Accepting new patients

Locations

3200 Grand Ave
Des Moines, IA 50312
Phone (515) 271-1700

1555 Hull Ave
Des Moines, IA 50316
Phone (515) 262-5639

8025 Grand Ave
West Des Moines, IA 50266
Phone (515) 271-1400

Interoperability endpoints

  • Direct secure messaging: jolene.givant.1@11667.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1073505780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 GRAND AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503124104",
            "telephone_number": "515-271-1710",
            "fax_number": "515-271-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 GRAND AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503124104",
            "telephone_number": "515-271-1710",
            "fax_number": "515-271-1575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIVANT",
        "first_name": "JOLENE",
        "middle_name": "MARIE",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "01164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.