Organization Active NPI

Jerome a Cohn DPM PC

  • Podiatrist
  • Goodyear, AZ
National Provider Identifier
1760413421
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
JEROME A COHN DPM PC
Practice address
13555 W McDowell Rd
Suite 301
Goodyear, AZ 85395-2629
Phone
(623) 848-0123
Fax
(623) 848-1153
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Authorized official

Name
Joel T. Bowen II, MDNPI 1831340736
Title
Owner/Physician
Phone
(623) 848-0123

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

13555 W McDowell Rd
Suite 301
Goodyear, AZ 85395-2629

Mailing address

13555 W McDowell Rd
Ste 301
Goodyear, AZ 85395-2629
Phone (623) 848-0123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040706001119 AZ Part B Supplier - Clinic/Group Practice 6709863814 Receives reassigned benefits from 2 practitioners
Practice locations: Goodyear, AZ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

13555 W McDowell Rd
Ste 301
Goodyear, AZ 85395
Phone (623) 848-0123

5432 E Southern Ave
Ste 101B
Mesa, AZ 85206
Phone (480) 210-3336

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458086400000",
    "number": "1760413421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13555 W MCDOWELL RD",
            "address_2": "STE 301",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952629",
            "telephone_number": "623-848-0123",
            "fax_number": "623-848-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13555 W MCDOWELL RD",
            "address_2": "SUITE 301",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952629",
            "telephone_number": "623-848-0123",
            "fax_number": "623-848-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEROME A COHN DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2016-03-16",
        "status": "A",
        "authorized_official_last_name": "BOWEN",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "623-848-0123",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.