Individual provider Active NPI

Kristen Michelle McGown, PT, DPT, ATC, LAT

  • Physical Therapist
  • Des Moines, IA
National Provider Identifier
1346768736
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
082568 Issued in IA
Practice address
2555 Guthrie Ave BLDG C
Des Moines, IA 50317-3091
Phone
(515) 299-1729
NPI assigned
Sep 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 001187 IA
Physical Therapist 225100000X 082568 IA Primary

Addresses

Primary practice location

2555 Guthrie Ave BLDG C
Des Moines, IA 50317-3091

Mailing address

2555 Guthrie Ave BLDG C
Des Moines, IA 50317-3091
Phone (515) 299-1729

Other names 1

  • Kristen Michelle O'Donnell Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171024002212 IA Practitioner - Physical Therapist in Private Practice 4082980735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1905 Ingersoll Ave
Suite 104
Des Moines, IA 50309-3305
Phone (515) 369-2306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001187IAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Valley Physical Therapy Center Physical Therapist CurrentSince Oct 16, 2017 Accepting new patients
Rock Valley Physical Therapy Center Physical Therapist CurrentSince Oct 16, 2017 Accepting new patients

Locations

1905 Ingersoll Ave
Ste 104
Des Moines, IA 50309
Phone (515) 369-2306

850 43rd Ave
Ste 100
Moline, IL 61265
Phone (309) 743-2070

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": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1346768736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 GUTHRIE AVE BLDG C",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503173091",
            "telephone_number": "515-299-1729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 GUTHRIE AVE BLDG C",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503173091",
            "telephone_number": "515-299-1729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWN",
        "first_name": "KRISTEN",
        "middle_name": "MICHELLE",
        "credential": "PT, DPT,  ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-06",
        "last_updated": "2022-07-21",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "001187",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "082568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "O'DONNELL",
            "middle_name": "MICHELLE",
            "credential": "PT, DPT,  ATC, LAT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.