Kepono Alvis Ross Gowan

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

Sneads Ferry Rd
Camp Lejeune, NC 28542

Phone

(910) 451-8155

NPI assigned

Mar 10, 2022

Last updated

Mar 10, 2022By 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

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": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1629725536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 CLAY HILL RD",
            "city": "SNEADS FERRY",
            "state": "NC",
            "postal_code": "284609778",
            "telephone_number": "808-800-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SNEADS FERRY RD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "28542",
            "telephone_number": "910-451-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOWAN",
        "first_name": "KEPONO",
        "middle_name": "ALVIS ROSS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-10",
        "last_updated": "2022-03-10",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Bree Gonzales, DMD
• Charles Michael Goodman, MD
• Miranda Goodman, IDC
• Scott Michael Goodwin, DO
• Jennifer Lee Gordon, MD
• Emerson Franklin Gower
• Robert Brett Goy, D.O.
• John Carl Grady III, M.D.
• Andrew Clifford Graf, MD
• Stephanie Grafius, RDH

• Independent Duty Corpsman in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• Independent Duty Corpsman in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.