Individual provider Active NPI

James W McKown, MD

  • Pediatrics Physician
  • Mesa, AZ
National Provider Identifier
1255305611
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
24928 Issued in AZ
Practice address
1400 S Dobson Rd
Mesa, AZ 85202
Phone
(480) 456-9500
Fax
(480) 820-7623
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 24928 AZ Primary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 24928 AZ

Addresses

Primary practice location

1400 S Dobson Rd
Mesa, AZ 85202

Mailing address

PO Box 7127
Phoenix, AZ 85011-7127
Phone (480) 456-9500

Other identifiers 1

IdentifierTypeStateIssuer
382284MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160923001701 WA Practitioner - Pediatric Medicine 5395735161 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24928AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Children's Hospital Current Accepting new patients
Progressive Medical Associates PLLC Past Accepting new patients

Locations

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

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.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1255305611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7127",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850117127",
            "telephone_number": "480-456-9500",
            "fax_number": "480-820-7623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S DOBSON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85202",
            "telephone_number": "480-456-9500",
            "fax_number": "480-820-7623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKOWN",
        "first_name": "JAMES",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "24928",
            "primary": true
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "AZ",
            "license": "24928",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382284",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.