DR. KEVIN POTHOVEN (NPI# 1053368498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053368498 |
| Entity Type | Individual |
| Full Name | DR. KEVIN POTHOVEN |
| Credential | M.D. |
| Practice Address |
1111 6th Ave Des Moines IA 50314-2613 |
| Mailing Address |
Po Box 4925 Des Moines IA 50305-4925 |
| Practice Telephone | 5152473211 |
| Practice Fax Number | 5156438722 |
| Mailing Telephone | 5156434374 |
| Mailing Fax Number | 5156432784 |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2009-06-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
4301078608 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BC/BS OF MICHIGAN | KP078608 | 01 |
| IA | BC/BS OF IOWA | 06127 | 01 |
| MI | 104631572 | 05 | |
| MI | 104703457 | 05 |
| Street Address |
1111 6TH AVE |
| City | DES MOINES |
| State | IA |
| Zip Code | 50314-2613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790785004 | Keven Odell Cutler | Emergency Medicine | 1111 6th Ave, Emergency Dept, Des Moines, IA 50314-2613 | 2005-07-28 |
| 1508470014 | Tammie Jordan | Pharmacist | 1111 6th Ave, Des Moines, IA 50314-2613 | 2020-09-02 |
| 1942812243 | Samantha Marie Ulsh | Nurse Practitioner | 1111 6th Ave, Des Moines, IA 50314-2613 | 2020-08-18 |
| 1962020677 | Jordyn Hauser | Dietitian, Registered | 1111 6th Ave, Des Moines, IA 50314-2613 | 2020-07-09 |
| 1659996528 | Doh Joon Park | Internal Medicine | 1111 6th Ave, Des Moines, IA 50314-2613 | 2020-06-16 |
| 1508481623 | Maianh T Tran | Surgery | 1111 6th Ave, Des Moines, IA 50314-2613 | 2020-06-15 |
| 1083239081 | Max E Reiche | Family Medicine | 1111 6th Ave, Des Moines, IA 50314-2613 | 2020-06-15 |
| 1760007488 | Obidike P Nwadike | Family Medicine | 1111 6th Ave, Des Moines, IA 50314-2613 | 2020-06-09 |
| 1154945970 | Jason C Wang | Internal Medicine | 1111 6th Ave, Des Moines, IA 50314-2613 | 2020-06-08 |
| 1588288435 | Elliot M Deblieck | Family Medicine | 1111 6th Ave, Des Moines, IA 50314-2613 | 2020-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982266979 | Dental Connections, Inc. | Dentist | 1111 9th Street, Suite 190, Des Moines, IA 50314 | 2019-07-01 |
| 1760910723 | Kelsey Taylor | Social Worker | 1761 Hickman Rd, Des Moines, IA 50314 | 2017-06-02 |
| 1184085672 | Allison J Robbins | Counselor | 1063 14th Place, Suite A, Des Moines, IA 50314 | 2016-03-11 |
| 1083081715 | Taylor Witzel | Specialist/Technologist | 450 Laurel Street, Des Moines, IA 50314 | 2015-08-28 |
| 1376893933 | Caring Hearts LLC | In Home Supportive Care | 1620 Pleasant, #245, Des Moines, IA 50314 | 2012-09-11 |
| 1104117522 | Akinbode Solomon Egbelakin | Pediatrics | 1111 6th Ave # Main3, Des Moines, IA 50314 | 2011-04-20 |
| 1447488325 | Abdelaziz Elhaddad | Internal Medicine | 95 University Avenue, Suite 1, Des Moines, IA 50314 | 2009-06-30 |
| 1356584080 | Tara Michelle Graff | Internal Medicine | 411 Laurel Street Suite A300, Des Moines, IA 50314 | 2009-04-10 |
| 1700068517 | Planned Parenthood of The Heartland | Family Medicine | 123 Clark Street, Des Moines, IA 50314 | 2007-12-04 |
| 1790903235 | Christy J. Meyer | Counselor | 1063 14th Place, Suite A, Des Moines, IA 50314 | 2007-04-22 |
| Find all providers in zip 50314 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972098150 | Amanda Sieve | Emergency Medicine | 1200 Pleasant St, Des Moines, IA 50309-1406 | 2018-06-29 |
| 1497953350 | Heather Noel Stein Poskevich | Emergency Medicine | 1111 6th Ave, Des Moines, IA 50314-2613 | 2007-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538140405 | Thomas Joseph Kafka | Emergency Medicine | Regional Medical Center, 709 West Main St., Manchester, IA 52057 | 2005-11-08 |
| 1477543668 | Michael M Rosenblatt | Emergency Medicine | 1605 Haskell St, Burlington, IA 52601-1406 | 2005-10-27 |
| 1508374927 | Kari Lynn Tessum | Emergency Medicine | 802 Kenyon Rd, Fort Dodge, IA 50501-5740 | 2018-01-19 |
| 1629312723 | Ottumwa Er LLC | Emergency Medicine | 1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 | 2012-11-15 |
| 1902162191 | Sarah Wolf Field | Emergency Medicine | 500 E Market St, Iowa City, IA 52245 | 2012-04-02 |
| 1235422056 | Brian Michael Kuchay | Emergency Medicine | 621 S Illinois Ave, Mason City, IA 50401-5405 | 2011-05-26 |
| 1689705949 | Jackson County Public Hospital | Emergency Medicine | 700 W Grove St, Maquoketa, IA 52060-2163 | 2007-03-08 |
| 1164593109 | Buena Vista Regional Medical Center | Emergency Medicine | 1525 W 5th St, Storm Lake, IA 50588-3027 | 2006-11-13 |
| 1326073669 | Delaware County Memorial Hospital | Emergency Medicine | 709 W Main St, Manchester, IA 52057-1526 | 2006-07-12 |
| 1811957590 | Michael Ambrose Cronkleton | Emergency Medicine | 1227 E Rusholme St, Davenport, IA 52803-2459 | 2006-03-25 |
| Find all providers with the same taxonomy | ||||
| City | DES MOINES |
| Zip Code | 50314 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.