Active NPI
David Kahn Roberts, PA
- Physician Assistant
- Des Moines, IA
National Provider Identifier
1891210183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 088587
- Practice address
- 1111 6TH Ave Ste B1
Des Moines, IA 50314-2610 - Phone
- (515) 358-0100
- Fax
- (515) 358-0109
- NPI assigned
- Aug 8, 2017
- Last updated
- Oct 8, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 088587 | IA | Primary |
Addresses
Primary practice location
1111 6TH Ave Ste B1
Des Moines, IA 50314-2610
Mailing address
PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 358-0100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 088587 | IA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538956800000",
"number": "1891210183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1475",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503051475",
"telephone_number": "515-358-0100",
"fax_number": "515-358-0109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 6TH AVE STE B1",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503142610",
"telephone_number": "515-358-0100",
"fax_number": "515-358-0109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "DAVID",
"middle_name": "KAHN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-08",
"last_updated": "2018-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IA",
"license": "088587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.