Chamnahn Kongtahworn, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

20052 Issued in IA

Practice address

12950 Woodlands Pkwy
Clive, IA 50325-8748

Phone

(515) 225-2369

NPI assigned

Dec 20, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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 Heart Center PC

  • Cardiovascular Disease Physician
  • West Des Moines, IA
  • NPI 1164410932

  Thoracic Surgery (Cardiothoracic Vascular Surgery)

  NPD (past)

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1982973970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12950 WOODLANDS PKWY",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258748",
            "telephone_number": "515-225-2369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12950 WOODLANDS PKWY",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258748",
            "telephone_number": "515-225-2369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONGTAHWORN",
        "first_name": "CHAMNAHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-20",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IA",
            "license": "20052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "20052",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monty Kluger, DC
• Jillian Knittle, PHARMD
• Kimberly Knuth, RBT
• Meghan Elizabeth Kobes
• Musa Kibyegon Koech
• Anthony Daniel Kopp, DO
• Radhika Kota, R.PH
• Caitlin Zoe Kotz, BCBA
• Karina Kovalenko
• Curis Kozlowski

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Clive, IA
• Providers in Clive, IA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; 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.