Individual provider Active NPI

Carmela Rosa Cowdrey, D.O.

  • Psychiatry Physician
  • Goshen, IN
National Provider Identifier
1396060539
Registry record updated Apr 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
02004421A Issued in IN
Practice address
330 Lakeview Dr
Psychiatry and Behavioral Neurosciences
Goshen, IN 46528-9365
Phone
(574) 533-1234
Fax
(574) 537-2652
NPI assigned
Mar 31, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 02004421A IN Primary
Psychiatry Physician 2084P0800X 036131283 IL

Addresses

Primary practice location

330 Lakeview Dr
Psychiatry and Behavioral Neurosciences
Goshen, IN 46528-9365

Mailing address

PO Box 809
Goshen, IN 46527-0809
Phone (574) 533-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140729000957 IN Practitioner - Psychiatry 5799901716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oaklawn Psychiatric Center IncGroup PAC ID 6002801065, 66 clinicians

Practice addresses (Care Compare)

330 Lakeview Dr
Goshen, IN 46528-9365
Phone (574) 533-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036131283ILMDPsychiatry Physician
02004421AINMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oaklawn Psychiatric Center, Inc. CurrentSince Apr 11, 2016 Accepting new patients
Oaklawn Psychiatric Center, Inc. CurrentSince Apr 11, 2016 Accepting new patients
Wabash Valley Urological Assoc Inc Past Accepting new patients

Locations

330 Lakeview Dr
Goshen, IN 46528
Phone (219) 533-1234

Interoperability endpoints

  • Direct secure messaging: ccowdrey@mybeacon.cernerdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1269993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1396060539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 809",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465270809",
            "telephone_number": "574-533-1234",
            "fax_number": "574-537-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 LAKEVIEW DR",
            "address_2": "PSYCHIATRY AND BEHAVIORAL NEUROSCIENCES",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465289365",
            "telephone_number": "574-533-1234",
            "fax_number": "574-537-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWDREY",
        "first_name": "CARMELA",
        "middle_name": "ROSA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-31",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "02004421A",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036131283",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

Verify at the official NPI Registry.