Individual provider Active NPI

Jessica Bowman, FNP-BC

  • Nurse Practitioner
  • Fairfax, MO
National Provider Identifier
1083367817
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2021046379 Issued in MO
Practice address
26136 US Highway 59
Fairfax, MO 64446-9105
Phone
(660) 686-2211
NPI assigned
Feb 1, 2022
Last updated
Feb 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2021046379 MO Primary

Addresses

Primary practice location

26136 US Highway 59
Fairfax, MO 64446-9105

Mailing address

9649 County Road 73
Fillmore, MO 64449-9183
Phone (816) 387-1519

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20230331000583 MO Practitioner - Nurse Practitioner 4688049802 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Hospital AssociationGroup PAC ID 1557316783, 8 clinicians

Practice addresses (Care Compare)

514 State St
Mound City, MO 64470-1145
Phone (660) 442-3181

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Hospital Urgent Care, LLC CurrentSince Mar 1, 2023 Accepting new patients
Community Hospital Association Current Accepting new patients

Locations

26136 US Highway 59
Fairfax, MO 64446
Phone (660) 686-2211

8300 N Church Rd
Kansas City, MO 64158
Phone (816) 407-2300

Interoperability endpoints

  • Direct secure messaging: jessica.bowman.p11@direct.nlhc.nextgenshare.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1083367817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9649 COUNTY ROAD 73",
            "city": "FILLMORE",
            "state": "MO",
            "postal_code": "644499183",
            "telephone_number": "816-387-1519",
            "fax_number": "660-686-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26136 US HIGHWAY 59",
            "city": "FAIRFAX",
            "state": "MO",
            "postal_code": "644469105",
            "telephone_number": "660-686-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "JESSICA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2021046379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, MO

Sources for this page

Verify at the official NPI Registry.