Individual provider Active NPI

Jennifer A. Bowman, DNP, MBA, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Canonsburg, PA
National Provider Identifier
1003218280
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP014192 Issued in PA
Practice address
135 Technology Dr Ste 204
Canonsburg, PA 15317-9549
Phone
(724) 399-3931
NPI assigned
Sep 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP014192 PA Primary

Addresses

Primary practice location

135 Technology Dr Ste 204
Canonsburg, PA 15317-9549

Mailing address

135 Technology Dr Ste 204
Canonsburg, PA 15317-9549
Phone (724) 399-3931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150831002984 PA Practitioner - Nurse Practitioner 0749596161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

135 Technology Dr
Suite 204
Canonsburg, PA 15317-9549
Phone (724) 399-3931

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer a Bowman DNP Pmhnp LLC Psychiatric/Mental Health CurrentSince Nov 1, 2023 Accepting new patients
Southpointe Psychiatry & Wellness, LLC Psychiatric/Mental Health PastSince Jan 1, 2025 Accepting new patients

Locations

135 Technology Dr
Ste 204
Canonsburg, PA 15317
Phone (412) 478-4690

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1003218280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 TECHNOLOGY DR STE 204",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153179549",
            "telephone_number": "724-399-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 TECHNOLOGY DR STE 204",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153179549",
            "telephone_number": "724-399-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "JENNIFER",
        "middle_name": "A.",
        "credential": "DNP, MBA, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-19",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP014192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canonsburg, PA

Sources for this page

Verify at the official NPI Registry.