Individual provider Active NPI

Kyle Kosman, RN

  • Family Nurse Practitioner
  • Johnston, IA
National Provider Identifier
1174014484
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A127959 Issued in IA
Practice address
9122 NW Windsor Dr
Johnston, IA 50131-2239
Phone
(515) 505-9011
NPI assigned
May 22, 2018
Last updated
Jan 31, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 127959 IA
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X A127959 IA Primary

Addresses

Primary practice location

9122 NW Windsor Dr
Johnston, IA 50131-2239

Mailing address

9122 NW Windsor Dr
Johnston, IA 50131-2239
Phone (515) 505-9011

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
I20181113002523 IA Practitioner - Nurse Practitioner 3678827524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

801 Colonial Cir
Norwalk, IA 50211-9626
Phone (515) 285-3200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
127959IAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation Single Specialty CurrentSince Nov 12, 2018 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

101 SE Destination Dr
Grimes, IA 50111
Phone (515) 986-4524

801 Colonial Cir
Norwalk, IA 50211
Phone (515) 285-3200

8101 Birchwood Ct
Unit R
Urbandale, IA 50131
Phone (515) 471-9363

Interoperability endpoints

  • Direct secure messaging: kkosman653176@direct.unitypoint.org

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1174014484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9122 NW WINDSOR DR",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312239",
            "telephone_number": "515-505-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9122 NW WINDSOR DR",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312239",
            "telephone_number": "515-505-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSMAN",
        "first_name": "KYLE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-22",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IA",
            "license": "127959",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A127959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, IA

Sources for this page

Verify at the official NPI Registry.