Kiley Ottervanger, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

DO-04638 Issued in IA

Practice address

6000 University Ave Ste 100
West Des Moines, IA 50266-8200

Phone

(515) 241-2500

NPI assigned

Jun 27, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kottervanger34346@direct.unitypoint.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Iowa Physicians Clinic Medical Foundation

  • General Practice Physician
  • West Des Moines, IA
  • NPI 1366425274

  Pediatrics

  Medicare reassignment NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1942564745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 UNIVERSITY AVE STE 100",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668200",
            "telephone_number": "515-241-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 UNIVERSITY AVE STE 100",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668200",
            "telephone_number": "515-241-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTERVANGER",
        "first_name": "KILEY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "R-9571",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "DO-04638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942564745",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charleen Annette Ostrem, ARNP
• Melissa Ostrem
• Cory Martin Oswald, DPT
• Pier Louise Osweiler, ARNP
• Erich Winfield Ottervanger, PT, DPT
• Jeremy S Overbaugh, LISW
• Jennifer A Overton, OD
• Rachel A Overton, MD
• Roy William Overton III, DO
• Jacarie Eileen Owens, MS, LMHC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.