Alexis Nicole Bowder, MD

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

73261 Issued in TN

Practice address

325 N State of Franklin Rd FL 3
Johnson City, TN 37604-6171

Phone

(423) 439-7201

NPI assigned

Apr 11, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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.

Enrollment records 1

Specialty

General Surgery

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Education Assistance CorporationGroup PAC ID 3870491269, 168 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abowder528677@balladhealth.medalliesdirect.net

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.

• Medical Education Assistance Corporation

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1235180480
  Medicare reassignment Care Compare group NPD
• Wellmont Health System

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1760405849
  NPD

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1063876589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N STATE OF FRANKLIN RD FL 3",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046171",
            "telephone_number": "423-439-7201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-8632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWDER",
        "first_name": "ALEXIS",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "TN",
            "license": "73261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Wehunt Bourassa, PT, DPT, NCS, ATC
• Natasha Bourgoin
• Katherine Paige Bourne, PA-C
• Michelle Bouton, L.AC., M.A.O.M.
• Kelsey Bowden, COTA/L
• Shasta Nicole Bowens, APRN FNP-C
• Brandon Bowers, OTD
• Brit Edwin Bowers, D.D.S.
• Derek Shea Bowers, LCSW
• Jerrie Sue Bowers, BS

• Pediatric Surgery Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Pediatric Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.

Verify at the official NPI Registry.