Active NPI
Peter Economos
- Student in an Organized Health Care Education/Training Program
- Des Moines, IA
National Provider Identifier
1497596779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1233 63Rd St
Des Moines, IA 50311-1943 - Phone
- (515) 277-6358
- NPI assigned
- Jun 3, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1233 63Rd St
Des Moines, IA 50311-1943
Mailing address
1955 NW 129TH St
Clive, IA 50325-7501
Phone (515) 494-4534
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iowa Dental Group LLC | Single Specialty | Current | Accepting new patients |
Locations
1233 63rd St
Des Moines, IA 50311
Phone (515) 277-6358
Organizations & group practices 1
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": "1717372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717372800000",
"number": "1497596779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1955 NW 129TH ST",
"city": "CLIVE",
"state": "IA",
"postal_code": "503257501",
"telephone_number": "515-494-4534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1233 63RD ST",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503111943",
"telephone_number": "515-277-6358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECONOMOS",
"first_name": "PETER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-06-03",
"last_updated": "2024-06-03",
"certification_date": "2024-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.