NPIMap

Organization Active NPI

Bowen Primary & Urgent Care PA

  • Internal Medicine Physician
  • Hickory, NC
National Provider Identifier
1003956079
Registry record updated Oct 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BOWEN PRIMARY & URGENT CARE PA
Practice address
116 3Rd St NW
Hickory, NC 28601-6137
Phone
(828) 855-1192
Fax
(828) 471-3990
NPI assigned
Feb 7, 2007
Last updated
Oct 5, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2017

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

Authorized official

Name
Stephany Carroll
Title
Office Manager
Phone
(828) 855-1192

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NC Primary

Addresses

Primary practice location

116 3Rd St NW
Hickory, NC 28601-6137

Mailing address

PO Box 2268
Hickory, NC 28603-2268
Phone (828) 855-1192

Other identifiers 1

IdentifierTypeStateIssuer
8901779MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080925000039 NC Part B Supplier - Clinic/Group Practice 6103909098 Receives reassigned benefits from 24 practitioners
Practice locations: Hickory, NC

National Provider Directory

National Provider Directory

Locations

116 3rd St NE
Ste 102
Hickory, NC 28601
Phone (828) 855-1192

116 3rd St NW
#102
Hickory, NC 28601
Phone (828) 855-1192

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507161600000",
    "number": "1003956079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2268",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286032268",
            "telephone_number": "828-855-1192",
            "fax_number": "828-471-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 3RD ST NW",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286016137",
            "telephone_number": "828-855-1192",
            "fax_number": "828-471-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOWEN PRIMARY & URGENT CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2017-10-05",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "STEPHANY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "828-855-1192"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901779",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.