Individual provider Active NPI

Amanda Sue Bowman, NP-C

  • Family Nurse Practitioner
  • Bedford, IN
National Provider Identifier
1053841254
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71007172A Issued in IN
Practice address
629 Lincoln Ave
Bedford, IN 47421-2142
Phone
(812) 675-4470
Fax
(812) 675-4469
NPI assigned
Jun 20, 2017
Last updated
Jul 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71007172A IN Primary

Addresses

Primary practice location

629 Lincoln Ave
Bedford, IN 47421-2142

Mailing address

420 W Longest St
Paoli, IN 47454-8821
Phone (812) 723-3944

Other practice location 1

2516 Q St
Bedford, IN 47421-4928
Phone (812) 275-4228

Other practice location 2

2512 Q St
Bedford, IN 47421-4928
Phone (812) 675-4470

Other practice location 3

2512 Q St
Bedford, IN 47421-4928
Phone (812) 675-4470

Other identifiers 1

IdentifierTypeStateIssuer
300005578MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170818001578 IN Practitioner - Nurse Practitioner 5799057147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

420 W Longest St
Paoli, IN 47454-8821
Phone (812) 723-3944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71007172AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Indiana Community Health Care, Inc CurrentSince Jan 6, 2023 Accepting new patients
Southern Indiana Community Health Care, Inc Current Accepting new patients
Southern Indiana Community Health Care, Inc CurrentSince Jan 6, 2023 Accepting new patients
Southern Indiana Community Health Care, Inc Past Accepting new patients
Southern Indiana Community Health Care, Inc Past Accepting new patients

Locations

2512 Q St
Bedford, IN 47421
Phone (812) 277-9692

629 Lincoln Ave
Bedford, IN 47421
Phone (812) 277-1702

2759 State Road 37
Mitchell, IN 47446
Phone (812) 849-6420

420 W Longest St
Paoli, IN 47454
Phone (812) 723-3944

Interoperability endpoints

  • Direct secure messaging: amandabowman@sichc.allscriptsdirect.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1053841254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W LONGEST ST",
            "city": "PAOLI",
            "state": "IN",
            "postal_code": "474548821",
            "telephone_number": "812-723-3944",
            "fax_number": "812-723-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 LINCOLN AVE",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474212142",
            "telephone_number": "812-675-4470",
            "fax_number": "812-675-4469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2516 Q St",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "IN",
            "postal_code": "474214928",
            "country_code": "US",
            "telephone_number": "812-275-4228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2512 Q St",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "IN",
            "postal_code": "474214928",
            "country_code": "US",
            "telephone_number": "812-675-4470",
            "fax_number": "812-675-4469",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2512 Q St",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "IN",
            "postal_code": "474214928",
            "country_code": "US",
            "telephone_number": "812-675-4470",
            "fax_number": "812-675-4469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "AMANDA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007172A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300005578",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, IN

Sources for this page

Verify at the official NPI Registry.