Individual provider Active NPI

Cowan Stevens

  • Community Health Worker
  • Kent, OH
National Provider Identifier
1104597046
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
CHW.001604 Issued in OH
Practice address
143 Gougler Ave
Kent, OH 44240-2401
Phone
(234) 788-4438
Fax
(330) 564-9986
NPI assigned
Sep 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X CHW.001604 OH Primary

Addresses

Primary practice location

143 Gougler Ave
Kent, OH 44240-2401

Mailing address

PO Box 933132
Cleveland, OH 44193-0036
Phone (888) 975-9188

Other practice location 1

390 Robinson Ave Ste E
Barberton, OH 44203-3659
Phone (888) 975-9188

Other practice location 2

1400 S Arlington St Unit 38
Akron, OH 44306-3771
Phone (888) 975-9188

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
CHW.001604OHMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1104597046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933132",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930036",
            "telephone_number": "888-975-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 GOUGLER AVE",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442402401",
            "telephone_number": "234-788-4438",
            "fax_number": "330-564-9986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "390 Robinson Ave Ste E",
            "address_purpose": "LOCATION",
            "city": "Barberton",
            "state": "OH",
            "postal_code": "442033659",
            "country_code": "US",
            "telephone_number": "888-975-9188",
            "fax_number": "330-564-9989",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 S Arlington St Unit 38",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443063771",
            "country_code": "US",
            "telephone_number": "888-975-9188",
            "fax_number": "330-564-9977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "COWAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OH",
            "license": "CHW.001604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.