Thomas Fancis Gowen Jr., RN

Primary specialty

Nephrology Registered NurseTaxonomy code 163WN0300X

License

136999 Issued in MO

Practice address

272 Mayfair Plaza Shopping Ctr
Florissant, MO 63033-8009

Phone

(314) 859-1234

NPI assigned

Mar 17, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1336897370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7710 ELTON ST",
            "city": "GRANTWOOD VLG",
            "state": "MO",
            "postal_code": "631233806",
            "telephone_number": "314-598-2867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 MAYFAIR PLAZA SHOPPING CTR",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630338009",
            "telephone_number": "314-859-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOWEN",
        "first_name": "THOMAS",
        "middle_name": "FANCIS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-17",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0300X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nephrology",
            "state": "MO",
            "license": "136999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Florissant, MO
• Providers in Florissant, MO by specialty
• Registered Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.