Individual provider Active NPI

Evan Koenen, DC

  • Chiropractor
  • Ames, IA
National Provider Identifier
1306574017
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
115358 Issued in IA
Practice address
2714 Aspen Rd Ste 103
Ames, IA 50010-4485
Phone
(515) 441-7100
NPI assigned
Aug 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 115358 IA Primary

Addresses

Primary practice location

2714 Aspen Rd Ste 103
Ames, IA 50010-4485

Mailing address

2714 Aspen Rd Ste 103
Ames, IA 50010-4485
Phone (515) 441-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240209000644 IA Practitioner - Chiropractic 2567805237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1605 SE Delaware Ave
Suite D
Ankeny, IA 50021-4595
Phone (515) 777-1104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
115358IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Family Chiropractic Ames, P.C. Chiropractor CurrentSince Aug 14, 2022 Accepting new patients
Iowa Family Chiropractic Ankeny Inc. Chiropractor CurrentSince Dec 20, 2023 Accepting new patients

Locations

2714 Aspen Rd
Ste 103
Ames, IA 50010
Phone (515) 441-7100

1605 SE Delaware Ave
Ste D
Ankeny, IA 50021
Phone (515) 777-1104

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1306574017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2714 ASPEN RD STE 103",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500104485",
            "telephone_number": "515-441-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2714 ASPEN RD STE 103",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500104485",
            "telephone_number": "515-441-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENEN",
        "first_name": "EVAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "115358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ames, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.