Individual provider Active NPI

Jacqueline M Stoken, D.O.

  • Physical Medicine & Rehabilitation Physician
  • West Des Moines, IA
National Provider Identifier
1508895772
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
2849 Issued in IA
Practice address
1454 30TH St Ste 109
West Des Moines, IA 50266-1311
Phone
(515) 327-0046
Fax
(515) 327-9389
NPI assigned
Jul 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 2849 IA Primary

Addresses

Primary practice location

1454 30TH St Ste 109
West Des Moines, IA 50266-1311

Mailing address

1454 30TH St Ste 109
West Des Moines, IA 50266-1311
Phone (515) 327-0046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20050422000396 IA Practitioner - Physical Medicine and Rehabilitation 5698765873

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2849IAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boone County Hospital Past Accepting new patients

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": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1508895772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1454 30TH ST STE 109",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661311",
            "telephone_number": "515-327-0046",
            "fax_number": "515-327-9389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 30TH ST STE 109",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661311",
            "telephone_number": "515-327-0046",
            "fax_number": "515-327-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOKEN",
        "first_name": "JACQUELINE",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-01",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IA",
            "license": "2849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.