Derek Cowen, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

505 Rimkus Drive
Scott Air Force Base, IL 62225

Phone

(940) 636-2753

NPI assigned

Jul 27, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248652800000",
    "number": "1477784312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 RIMKUS DRIVE",
            "city": "SCOTT AIR FORCE BASE",
            "state": "IL",
            "postal_code": "62225",
            "telephone_number": "940-636-2753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 RIMKUS DRIVE",
            "city": "SCOTT AIR FORCE BASE",
            "state": "IL",
            "postal_code": "62225",
            "telephone_number": "940-636-2753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWEN",
        "first_name": "DEREK",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-27",
        "last_updated": "2009-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glen C Bolton, PSY.D.
• John A Brewster, DDS
• Thanh Bui, IDMT
• Cynthia Cain, LCSW
• Jesse Chang, DO
• Caitlin M Cox
• Anick Diessongo
• Sheila Bonnie Durlester, PNP
• Cheryl Lynn Frietch, R.D.
• Leeann Jeanette Funk, LCSW

• Independent Duty Medical Technicians in Scott Air Force Base, IL
• Providers in Scott Air Force Base, IL by specialty
• Independent Duty Medical Technicians in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2009; 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.