Daniel Mark Bowersox, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1301DT Issued in KY

Practice address

403 Washington St
Shelbyville, KY 40065-1127

Phone

(502) 647-3937

Fax

(502) 633-7326

NPI assigned

Apr 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Bowersox Vision Center PSC

  • Optometrist
  • Shelbyville, KY
  • NPI 1720115702

  KY, Optometrist

  Medicare reassignment NPD Authorized official
• Eye Associates of Southern Indiana PC

  • Optometrist
  • Frankfort, KY
  • NPI 1962533851
  NPD (past)

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1013972405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 WASHINGTON ST",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651127",
            "telephone_number": "502-647-3937",
            "fax_number": "502-633-7326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 WASHINGTON ST",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651127",
            "telephone_number": "502-647-3937",
            "fax_number": "502-633-7326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWERSOX",
        "first_name": "DANIEL",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1301DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77013019",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tatiana Danielle Borzotra, TCADC
• Allison Leigh Bostedo
• Melissa Bouldin
• Marjorie Bounds
• Bowersox Vision Center PSC
• Lauren McKinch Bowling, OD
• Jessica Renee Bradley, TCADC
• Viola Brambila, TCM, SUD
• Kimberlyn Breaden
• Devon Breithart, OTR

• All providers in Shelbyville, KY
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2010; 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.

Verify at the official NPI Registry.