Mary McGowan, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

111952 Issued in NE

Practice address

3410 Futures Dr
South Sioux City, NE 68776-3917

Phone

(402) 412-7242

Fax

(712) 252-5920

NPI assigned

Jun 12, 2006

Last updated

Jun 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Mary Holmes Former name

Medicare fee-for-service enrollment

Enrolled in IA, NE2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmcgowan637137@direct.ochin.org

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

• Siouxland Community Health Center

  dba Siouxland Community Health Center of Nebraska

  • Federally Qualified Health Center (FQHC)
  • South Sioux City, NE
  • NPI 1912378480
  Medicare reassignment NPD
• Siouxland Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Sioux City, IA
  • NPI 1558355305
  Medicare reassignment NPD
• Diagnostic Radiology PC

  • Diagnostic Radiology Physician
  • Omaha, NE
  • NPI 1497713291
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1093757999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N SIOUX POINT RD",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495000",
            "telephone_number": "605-232-3332",
            "fax_number": "605-232-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 FUTURES DR",
            "city": "SOUTH SIOUX CITY",
            "state": "NE",
            "postal_code": "687763917",
            "telephone_number": "402-412-7242",
            "fax_number": "712-252-5920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N Sioux Point Rd",
            "address_purpose": "LOCATION",
            "city": "Dakota Dunes",
            "state": "SD",
            "postal_code": "570495000",
            "country_code": "US",
            "telephone_number": "605-232-3332",
            "fax_number": "605-232-0854",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1021 Nebraska St",
            "address_purpose": "LOCATION",
            "city": "Sioux City",
            "state": "IA",
            "postal_code": "511051436",
            "country_code": "US",
            "telephone_number": "712-252-2477",
            "fax_number": "712-252-5920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGOWAN",
        "first_name": "MARY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP000341",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A091311",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "111952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093757999",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093757999",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093757999",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "HOLMES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Curtis Mastbergen
• Adam James Mathers, DPT
• Matneys Colonial Manor, Inc.
• Gerald Lou Mayo III, MSW, PLMHP
• Darlakae McGheemahon, FAMILY THERAPIST
• Renae McInerney
• Justin Ryan McKibben
• Amy Elizabeth McManamy, LMSW, LIMHP
• Wendy McNear
• Mayra Mena

• Family Nurse Practitioner in South Sioux City, NE
• Providers in South Sioux City, NE by specialty
• Family Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.