Individual provider Active NPI

David P Bowman, D.O.

  • Family Medicine Physician
  • Stansbury Park, UT
National Provider Identifier
1053486076
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
8554520-1204 Issued in UT
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.

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
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
0-175IDMDFamily Medicine Physician
8554520-1204UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Axial-Im CurrentSince Jan 28, 2025 Accepting new patients
Tooele Clinic Corp Family Medicine CurrentSince Nov 10, 2015 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

  • FHIR API: https://api.platform.athenahealth.com/8822/brand/1/csg/1/fhir/r4

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0-175 ID
Family Medicine Physician 207Q00000X 8554520-1204 UT Primary

Addresses

NPPES NPI Registry

Primary 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

Verify at the official NPI Registry.