Individual provider Active NPI

Michael Shawn Bowlan, O.D.

  • Optometrist
  • Memphis, TN
National Provider Identifier
1083659684
Registry record updated Apr 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
649 Issued in MS
Practice address
6465 N Quail Hollow Rd
Memphis, TN 38120-1448
Phone
(662) 349-0320
Fax
(662) 349-1389
NPI assigned
Jun 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 649 MS Primary

Addresses

Primary practice location

6465 N Quail Hollow Rd
Memphis, TN 38120-1448

Mailing address

2709 Bienville Rd
Nesbit, MS 38651-9749
Phone (901) 834-9584

Other practice location 1

5740 Getwell Rd
Southaven, MS 38672-6346
Phone (662) 349-0320

Other names 1

  • Dr. Michael Shawn Hellums Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060818000328 MS Practitioner - Optometry 6507869294 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr. Richard C. Buck OD., PCGroup PAC ID 8921150566, 8 clinicians
West Tennessee Eye Care, PCGroup PAC ID 4789587759, 4 clinicians

Practice addresses (Care Compare)

338 Goodman Rd W
Southaven, MS 38671-9409
Phone (662) 510-7397

5740 Getwell Rd
BLDG 7
Southaven, MS 38672-7361
Phone (662) 349-0320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
649MSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Richard C. Buck OD PC Optometrist CurrentSince Jul 1, 2024 Accepting new patients

Locations

5218 Goodman Rd
Ste 113
Olive Branch, MS 38654
Phone (662) 269-6305

338 Goodman Rd W
Southaven, MS 38671
Phone (662) 349-1139

7706 Winchester Rd
Ste 105
Memphis, TN 38125
Phone (901) 752-1551

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776470400000",
    "number": "1083659684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 BIENVILLE RD",
            "city": "NESBIT",
            "state": "MS",
            "postal_code": "386519749",
            "telephone_number": "901-834-9584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 N QUAIL HOLLOW RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381201448",
            "telephone_number": "662-349-0320",
            "fax_number": "662-349-1389"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5740 Getwell Rd",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386726346",
            "country_code": "US",
            "telephone_number": "662-349-0320",
            "fax_number": "662-349-1389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWLAN",
        "first_name": "MICHAEL",
        "middle_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2026-04-18",
        "certification_date": "2026-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "HELLUMS",
            "middle_name": "SHAWN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.