Individual provider Active NPI

Ruth H McGowan, PA-C

  • Medical Physician Assistant
  • Maplewood, MN
National Provider Identifier
1205924156
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
12697 Issued in MN
Practice address
2945 Hazelwood St Ste 100
Maplewood, MN 55109-1242
Phone
(651) 232-7800
Fax
(651) 232-7940
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 001738 IA
Medical Physician Assistant 363AM0700X PA22945 CA
Medical Physician Assistant 363AM0700X 12697 MN Primary

Addresses

Primary practice location

2945 Hazelwood St Ste 100
Maplewood, MN 55109-1242

Mailing address

2945 Hazelwood St Ste 100
Maplewood, MN 55109-1242
Phone (651) 232-7800

Other practice location 1

444 Plumas Blvd
Yuba City, CA 95991-5071
Phone (530) 749-3420

Other identifiers 2

IdentifierTypeStateIssuer
P00466587OtherIARR MEDICARE
1205924156MedicaidIA

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
I20061218000189 IA Practitioner - Physician Assistant 5193724391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

2996 7TH Ave
Suite B
Marion, IA 52302-3713
Phone (319) 377-4844

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Hiawatha, IA, CCN 167124
  • Unitypoint at Home Home health agency, Cedar Rapids, IA, CCN 167005
  • St Lukes Hospital Hospital, Cedar Rapids, IA, CCN 160045
  • Jones Regional Medical Center Hospital, Anamosa, IA, CCN 161306

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001738IAMDMental Health Counselor
12697MNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation CurrentSince Sep 14, 2020 Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Sep 14, 2020 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Mercy Medical Center Past Accepting new patients
Iowa Cancer Care, PLC Past 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

2996 7th Ave
Ste B
Marion, IA 52302
Phone (319) 377-4844

Interoperability endpoints

  • Direct secure messaging: rmcgowan762196@direct.unitypoint.org

Organizations & group practices 5

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1205924156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2945 HAZELWOOD ST STE 100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091242",
            "telephone_number": "651-232-7800",
            "fax_number": "651-232-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 HAZELWOOD ST STE 100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091242",
            "telephone_number": "651-232-7800",
            "fax_number": "651-232-7940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "444 Plumas Blvd",
            "address_purpose": "LOCATION",
            "city": "Yuba City",
            "state": "CA",
            "postal_code": "959915071",
            "country_code": "US",
            "telephone_number": "530-749-3420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGOWAN",
        "first_name": "RUTH",
        "middle_name": "H",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "001738",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA22945",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "12697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00466587",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205924156",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.