NPIMap

Individual provider Active NPI

Jon R Bowen, MD

  • Family Medicine Physician
  • Chapmanville, WV
National Provider Identifier
1093929036
Registry record updated May 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22652 Issued in WV
Practice address
386 Airport Rd
Chapmanville, WV 25508-9202
Phone
(304) 855-1200
Fax
(304) 855-1230
NPI assigned
May 9, 2007
Last updated
May 8, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 22652 WV Primary

Addresses

Primary practice location

386 Airport Rd
Chapmanville, WV 25508-9202

Mailing address

PO Box 4013
Chapmanville, WV 25508-4013
Phone (304) 855-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080911000192 WV Practitioner - Family Practice 5991871204 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
JC Edwards School of Medicine, Marshall University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Health Access CorporationGroup PAC ID 2668528746, 12 clinicians

Practice addresses (Care Compare)

386 Airport Rd
Chapmanville, WV 25508-9202
Phone (304) 855-1200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Living Waters Medical Center CurrentSince Jan 6, 2020 Accepting new patients
Rural Health Access Corporation Family Medicine Current Accepting new patients
Rural Health Access Corporation CurrentSince Apr 30, 2012 Accepting new patients
Lincoln County Health Department Current Accepting new patients
Rural Health Access Corporation Family Medicine Past Accepting new patients
Lincoln County Primary Care Center, Inc Past Accepting new patients

Locations

384 Airport Rd
Chapmanville, WV 25508
Phone (304) 855-0224

386 Airport Rd
Chapmanville, WV 25508
Phone (304) 855-1200

100 Main Ave
Logan, WV 25601
Phone (304) 831-6700

Interoperability endpoints

  • Direct secure messaging: jon.bowen.1@16636.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Coalfield Health CenterChapmanville, WV, CCN 511978 Federally qualified health center Corporate Director
W-2 Managing Employee		 Apr 30, 2012
Apr 30, 2012
Coalfield Health CenterChapmanville, WV, CCN 581842 Federally qualified health center Corporate Director
W-2 Managing Employee		 Jan 1, 2022
Apr 30, 2012
Rural Health Access CorporationChapmanville, WV, CCN 581015 Federally qualified health center Corporate Director
W-2 Managing Employee		 Jan 1, 2022
Apr 30, 2012
Coalfield Health CenterChapmanville, WV, CCN 581093 Federally qualified health center W-2 Managing Employee Apr 30, 2012

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367971200000",
    "number": "1093929036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4013",
            "city": "CHAPMANVILLE",
            "state": "WV",
            "postal_code": "255084013",
            "telephone_number": "304-855-1200",
            "fax_number": "304-855-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "386 AIRPORT RD",
            "city": "CHAPMANVILLE",
            "state": "WV",
            "postal_code": "255089202",
            "telephone_number": "304-855-1200",
            "fax_number": "304-855-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "JON",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2013-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "22652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapmanville, WV

Sources for this page

Verify at the official NPI Registry.