Active NPI
David P Bowman, D.O.
- Family Medicine Physician
- Stansbury Park, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 8554520-1204
- Practice address
- 576 E Highway 138
Suite 350
Stansbury Park, UT 84074-4027 - Phone
- (435) 843-1342
- Fax
- (435) 775-9272
- NPI assigned
- Nov 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
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.
-
- Neuromusculoskeletal Medicine & OMM Physician
- Riverton, UT
- NPI 1740843697
-
- Family Medicine Physician
- Tooele, UT
- NPI 1073512364
-
- Optometrist
- Paintsville, KY
- NPI 1023069937
NPD (past) FAMILY MEDICINE
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- College of Osteo Med of the Pacific at Pomona, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3898 W Innovation Dr
Suite B
Riverton, UT 84065-6038
Phone (801) 210-2776
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130820000355 | UT | Practitioner - Family Practice | 7214832955 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0-175 | ID | MD | Family Medicine Physician |
| 8554520-1204 | UT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Axial-Im | Current | Accepting new patients | |
| Tooele Clinic Corp | Family Medicine | Current | Accepting new patients |
| Paintsville Hma Physician Management, LLC | Family Medicine | Past | Accepting new patients |
Locations
3898 W Innovation Dr
Ste B
Riverton, UT 84065
Phone (801) 210-2776
576 E Highway 138
Ste 350
Tooele, UT 84074
Phone (435) 843-1324
2321 N 400 E
Ste 300
Tooele, UT 84074
Phone (435) 833-9180
1264 W Village Main Dr
Unit A
West Valley City, UT 84119
Phone (801) 703-4622
Interoperability endpoints
- https://api.platform.athenahealth.com/8822/brand/1/csg/1/fhir/r4
Specialties & licenses 2
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0-175 | ID | |
| Family Medicine Physician | 207Q00000X | 8554520-1204 | UT | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
576 E Highway 138
Suite 350
Stansbury Park, UT 84074-4027
Mailing address
576 E Highway 138
Suite 350
Stansbury Park, UT 84074-4027
Phone (435) 843-1342
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 19, 2015.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447891200000",
"number": "1053486076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "576 E HIGHWAY 138",
"address_2": "SUITE 350",
"city": "STANSBURY PARK",
"state": "UT",
"postal_code": "840744027",
"telephone_number": "435-843-1342",
"fax_number": "435-775-9272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "576 E HIGHWAY 138",
"address_2": "SUITE 350",
"city": "STANSBURY PARK",
"state": "UT",
"postal_code": "840744027",
"telephone_number": "435-843-1342",
"fax_number": "435-775-9272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWMAN",
"first_name": "DAVID",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-22",
"last_updated": "2015-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "0-175",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "UT",
"license": "8554520-1204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stansbury Park, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.