Kelly Jo McGowan

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

121293 Issued in OH

Practice address

3038 Gallia St
Portsmouth, OH 45662-4813

Phone

(740) 355-0835

Fax

(740) 355-0835

NPI assigned

Mar 26, 2007

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295853620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3634 JUNIOR FURNACE POWELLSVILLE RD",
            "city": "FRANKLIN FURNACE",
            "state": "OH",
            "postal_code": "456298768",
            "telephone_number": "740-574-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3038 GALLIA ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624813",
            "telephone_number": "740-355-0835",
            "fax_number": "740-355-0835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWAN",
        "first_name": "KELLY",
        "middle_name": "JO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "121293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Luke McEntire
• Lauren McFadden
• Timarlo McFadden
• Keesha McGee, CDCA
• Stephen McGinnis
• Carl Wesley McGraw Jr., DO
• Zoey Nicole McGraw
• Jenna Jo McGuire
• Rachel McGuire
• Deanna McHenry

• All providers in Portsmouth, OH
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.