Thomas K Koithan PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

02799 Issued in IA

Legal business name

THOMAS K KOITHAN PC

Practice address

495 S 51St St Unit 40
West Des Moines, IA 50265-6988

Phone

(515) 883-0783

NPI assigned

Jul 29, 2009

Organization subpart

No

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

Authorized official

Name

Thomas Kirby Koithan, D.O.NPI 1235194143

Title

President

Phone

(515) 883-0783

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 1

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.

• Thomas Kirby Koithan, DO

  • Psychiatry Physician
  • Des Moines, IA
  • NPI 1235194143
  NPD (past) Authorized official

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248825600000",
    "number": "1821229519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 S 51ST ST UNIT 40",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502656988",
            "telephone_number": "515-883-0783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 S 51ST ST UNIT 40",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502656988",
            "telephone_number": "515-883-0783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS K KOITHAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-29",
        "last_updated": "2009-07-29",
        "status": "A",
        "authorized_official_last_name": "KOITHAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "KIRBY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-883-0783",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "02799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "I4144",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVDUAL NPI",
            "identifier": "1235194143",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0106294",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Psychiatry Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; 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.