Mary Leroy Khowassah, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

17924 Issued in IA

Practice address

4189 Westlawn S
University of Iowa Student Health Services
Iowa City, IA 52242-1100

Phone

(319) 335-8370

Fax

(319) 335-7247

NPI assigned

Sep 22, 2005

Last updated

Sep 28, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190937600000",
    "number": "1740276096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4189 WESTLAWN S",
            "address_2": "UNIVERSITY OF IOW STUDENT HEALTH SERVICES",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421100",
            "telephone_number": "319-335-8370",
            "fax_number": "319-335-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4189 WESTLAWN S",
            "address_2": "UNIVERSITY OF IOWA STUDENT HEALTH SERVICES",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421100",
            "telephone_number": "319-335-8370",
            "fax_number": "319-335-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOWASSAH",
        "first_name": "MARY",
        "middle_name": "LEROY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2007-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IA",
            "license": "17924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "08972",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0089722",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Komal Khoja, MD
• Charles Keo Khongmaly, RN
• Janet Kay Khongmaly, RN
• Brenden Khounlo
• Nabil Jose Khoury, MD
• Michal A Kidacki, MD, PHD
• Ryan M Kidder, LMSW
• Michael G Kienzle, MD
• Margaret W Kiiru-Zambrano
• Vicki Jo Kijewski, MD

• General Practice Physician in Iowa City, IA
• Providers in Iowa City, IA by specialty
• General Practice Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.