Ketch Cowan

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

338 Stevens Ave
Portland, ME 04103-2605

Phone

(207) 691-1992

NPI assigned

Apr 30, 2021

Last updated

Apr 30, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1457934192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 STEVENS AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032605",
            "telephone_number": "207-691-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 STEVENS AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032605",
            "telephone_number": "207-691-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWAN",
        "first_name": "KETCH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ketch.cowan@tufts.edu",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "338 Stevens Ave",
            "city": "Portland",
            "state": "ME",
            "country_code": "US",
            "postal_code": "041032605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Covetrus North America, LLC (Covetrus Maine)
• Wesley Carroll Covey
• Kimberly Jo Coville, LCSW
• Janette Renee Covington, MD
• Douglas Andrew Cowan, LCPC, LADC
• Joshua Cowgill, M.D.
• Samantha Larelle Cowling, PA-C
• Trevor Scott Cowling
• Brianne L Cox, CRNA
• Cydney J. Cox, M.D.

• Student in an Organized Health Care Education/Training Program in Portland, ME
• Providers in Portland, ME by specialty
• Student in an Organized Health Care Education/Training Program in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.