Active NPI
Jerald E. Bowmer, R.PH.
- Pharmacist
- Lenexa, KS
National Provider Identifier
1073790069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18762
- Practice address
- 17301 W 84TH Ter
Lenexa, KS 66219-8046 - Phone
- (913) 530-1493
- Fax
- (913) 599-5435
- NPI assigned
- Jan 22, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2003001219 | MO | |
| Pharmacist | 183500000X | 18762 | TX | Primary |
Addresses
Primary practice location
17301 W 84TH Ter
Lenexa, KS 66219-8046
Mailing address
17301 W 84TH Ter
Lenexa, KS 66219-8046
Phone (913) 530-1493
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18762 | TX | MD | General Practice Dentistry |
| 2003001219 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200960000000",
"number": "1073790069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17301 W 84TH TER",
"city": "LENEXA",
"state": "KS",
"postal_code": "662198046",
"telephone_number": "913-530-1493",
"fax_number": "913-599-5435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17301 W 84TH TER",
"city": "LENEXA",
"state": "KS",
"postal_code": "662198046",
"telephone_number": "913-530-1493",
"fax_number": "913-599-5435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWMER",
"first_name": "JERALD",
"middle_name": "E.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-22",
"last_updated": "2008-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2003001219",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "18762",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lenexa, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.