Kevan Scott Zechin Sr., M.D.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

32842 Issued in IA

Practice address

201 S Market St
Ottumwa, IA 52501-2924

Phone

(641) 683-5773

Fax

(641) 226-5759

NPI assigned

May 27, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194912000000",
    "number": "1508869124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 458",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525010458",
            "telephone_number": "641-683-5773",
            "fax_number": "641-226-5759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S MARKET ST",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525012924",
            "telephone_number": "641-683-5773",
            "fax_number": "641-226-5759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZECHIN",
        "first_name": "KEVAN",
        "middle_name": "SCOTT",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2007-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "IA",
            "license": "32842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0221176",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "421527584003",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "33686",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "42152758410",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin Lee Wyldes, CADC
• Nisreen M.a. H. Yaghmour, M.D.
• Clark Young, LMHC
• Marichris Zahnle, MD
• Shavea Noami Zapata Juan, PHARMD

• Federally Qualified Health Center (FQHC) in Ottumwa, IA
• Providers in Ottumwa, IA by specialty
• Federally Qualified Health Center (FQHC) in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; 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.