Active NPI
Jimmy Allen Bowman
- Denturist
- Merritt Island, FL
National Provider Identifier
1003121542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Denturist
- License
- 12232
- Practice address
- 950 N Courtenay Pkwy
Ste 2
Merritt Island, FL 32953-4501 - Phone
- (321) 631-3155
- Fax
- (321) 638-8684
- NPI assigned
- Aug 9, 2010
- Last updated
- Feb 7, 2017
- 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 |
|---|---|---|---|---|
| Denturist | 122400000X | 12232 | FL | Primary |
Addresses
Primary practice location
950 N Courtenay Pkwy
Ste 2
Merritt Island, FL 32953-4501
Mailing address
950 N Courtenay Pkwy
Ste 2
Merritt Island, FL 32953-4501
Phone (321) 631-3155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160715001608 | FL | Order and Referring Only - Oral Surgery | 6800188533 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12232 | FL | MD | Clinical Social Worker |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486425600000",
"number": "1003121542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 N COURTENAY PKWY",
"address_2": "STE 2",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "329534501",
"telephone_number": "321-631-3155",
"fax_number": "321-638-8684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 N COURTENAY PKWY",
"address_2": "STE 2",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "329534501",
"telephone_number": "321-631-3155",
"fax_number": "321-638-8684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWMAN",
"first_name": "JIMMY",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-09",
"last_updated": "2017-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "122400000X",
"taxonomy_group": "",
"desc": "Denturist",
"state": "FL",
"license": "12232",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merritt Island, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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.