Brevan Alan Bowman, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OT-A2027 Issued in AR

Practice address

1699 Red Wolf Blvd
Jonesboro, AR 72401-5442

Phone

(870) 336-0021

NPI assigned

Jun 19, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1003650698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5056 ABERDEEN RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724058184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1699 RED WOLF BLVD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015442",
            "telephone_number": "870-336-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "BREVAN",
        "middle_name": "ALAN",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OT-A2027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Bowen, RBT
• Peyton Bowen, MCD, CCC-SLP
• Sabrina Nannettee Bowen, NP
• Taylor Lynn Bowen, COTA/L
• Rudolph Noah Bowens Jr., MD
• John C Bowman, M.D.
• Raven Bowman
• Sharon H Bowman, M.D.
• Dorcy Bowser
• Tara N Boyce, LPC

• Occupational Therapy Assistant in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Occupational Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.