Individual provider Active NPI

Brian Bowers

  • Registered Dietitian
  • Philadelphia, PA
National Provider Identifier
1073913232
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN005523 Issued in PA
Practice address
2683 Winchester Ave
Philadelphia, PA 19152-2148
Phone
(215) 813-6334
NPI assigned
Aug 25, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DN005523 PA Primary

Addresses

Primary practice location

2683 Winchester Ave
Philadelphia, PA 19152-2148

Mailing address

2683 Winchester Ave
Philadelphia, PA 19152-2148
Phone (215) 813-6334

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN005523PAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1073913232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2683 WINCHESTER AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522148",
            "telephone_number": "215-813-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2683 WINCHESTER AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522148",
            "telephone_number": "215-813-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWERS",
        "first_name": "BRIAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-25",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN005523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.