Individual provider Active NPI

Meghan McGowan, CPNP-PC

  • Pediatric Nurse Practitioner
  • Gouverneur, NY
National Provider Identifier
1346801644
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
382979 Issued in NY
Practice address
77 W Barney St
Gouverneur, NY 13642-1040
Phone
(315) 535-1300
NPI assigned
Jun 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 382979 NY Primary
Registered Nurse 163W00000X 739805 NY

Addresses

Primary practice location

77 W Barney St
Gouverneur, NY 13642-1040

Mailing address

26116 Mountain LN
Evans Mills, NY 13637-3422
Phone (914) 629-0408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230830000227 NY Practitioner - Nurse Practitioner 0941663512 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
739805NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Family Medical Center Inc CurrentSince Jul 24, 2023 Accepting new patients
Open Door Family Medical Center Inc CurrentSince Jul 24, 2023 Accepting new patients
Open Door Family Medical Center, Inc. Past Accepting new patients

Locations

155 Main St
Brewster, NY 10509
Phone (845) 279-6999

689 Mamaroneck Ave
Mamaroneck, NY 10543
Phone (914) 253-1100

30 W Main St
Mount Kisco, NY 10549
Phone (914) 666-3272

165 Main St
Ossining, NY 10562
Phone (914) 941-1263

5 Grace Church St
Port Chester, NY 10573
Phone (914) 937-8899

300 N Broadway
Sleepy Hollow, NY 10591
Phone (914) 631-4141

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EAJCAA

Organizations & group practices 3

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": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1346801644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26116 MOUNTAIN LN",
            "city": "EVANS MILLS",
            "state": "NY",
            "postal_code": "136373422",
            "telephone_number": "914-629-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W BARNEY ST",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421040",
            "telephone_number": "315-535-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWAN",
        "first_name": "MEGHAN",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "382979",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "739805",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gouverneur, NY

Sources for this page

Verify at the official NPI Registry.