Individual provider Active NPI

Glenn Eric Hockett, MD

  • Family Medicine Physician
  • Des Moines, IA
National Provider Identifier
1992765994
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21658 Issued in IA
Practice address
5700 Hickman Rd
Des Moines, IA 50310-1121
Phone
(515) 274-3551
Fax
(515) 274-3512
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21658 IA Primary

Addresses

Primary practice location

5700 Hickman Rd
Des Moines, IA 50310-1121

Mailing address

5700 Hickman Rd
Des Moines, IA 50310-1121
Phone (515) 274-3551

Other identifiers 2

IdentifierTypeStateIssuer
183061MedicaidIA
1992765994MedicaidIA

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21658IAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1992765994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 HICKMAN RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503101121",
            "telephone_number": "515-274-3551",
            "fax_number": "515-274-3512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 HICKMAN RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503101121",
            "telephone_number": "515-274-3551",
            "fax_number": "515-274-3512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOCKETT",
        "first_name": "GLENN",
        "middle_name": "ERIC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "21658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183061",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992765994",
            "state": "IA"
        }
    ],
    "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 Aug 9, 2012; 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.