Active NPI
Charles Keo Khongmaly, RN
- Registered Nurse
- Iowa City, IA
National Provider Identifier
1184586570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 173276
- Practice address
- 601 Highway 6 W
Iowa City, IA 52246-2209 - Phone
- (319) 338-0581
- Fax
- (319) 887-4918
- NPI assigned
- Nov 24, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 173276 | IA | Primary |
Addresses
Primary practice location
601 Highway 6 W
Iowa City, IA 52246-2209
Mailing address
2090 F Ave NW
Cedar Rapids, IA 52405-2256
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 173276 | IA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1763942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763942400000",
"number": "1184586570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2090 F AVE NW",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524052256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 HIGHWAY 6 W",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522462209",
"telephone_number": "319-338-0581",
"fax_number": "319-887-4918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHONGMALY",
"first_name": "CHARLES",
"middle_name": "KEO",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-11-24",
"last_updated": "2025-11-24",
"certification_date": "2025-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IA",
"license": "173276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Iowa City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.