Individual provider Active NPI

Robert Bowen, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Towson, MD
National Provider Identifier
1073064176
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R208096 Issued in MD
Practice address
1200 E Joppa Rd
Towson, MD 21286-5810
Phone
(443) 798-7707
NPI assigned
Oct 24, 2016
Last updated
Feb 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R208096 MD Primary

Addresses

Primary practice location

1200 E Joppa Rd
Towson, MD 21286-5810

Mailing address

1200 E Joppa Rd
Towson, MD 21286-5810
Phone (443) 798-7707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20170105000108 MD Practitioner - Nurse Practitioner 8820379852 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

210 Colgate Dr
Forest Hill, MD 21050-1343
Phone (667) 450-6442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lucid Psychiatric Practice LLC Psychiatric/Mental Health CurrentSince Feb 14, 2018 Accepting new patients
Elysium, LLC Psychiatric/Mental Health CurrentSince Jan 26, 2024 Accepting new patients
Elysium, LLC CurrentSince Feb 18, 2024 Accepting new patients
Renewal Counseling Center, Inc CurrentSince Feb 23, 2017 Accepting new patients

Locations

201 Eastern Blvd
Essex, MD 21221

9414 Belair Rd
Ste 201
Nottingham, MD 21236
Phone (410) 529-2151

1200 E Joppa Rd
Ste A
Towson, MD 21286
Phone (443) 632-9302

Organizations & group practices 4

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": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1073064176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E JOPPA RD",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865810",
            "telephone_number": "443-798-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E JOPPA RD",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865810",
            "telephone_number": "443-798-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-24",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R208096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.