Individual provider Active NPI

Leland Harold Bowen, O.D.

  • Optometrist
  • Abbeville, SC
National Provider Identifier
1104001536
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1084 Issued in SC
Practice address
100 Trinity St
Abbeville, SC 29620-2130
Phone
(864) 366-2020
Fax
(864) 366-5108
NPI assigned
Jan 3, 2008
Last updated
Jun 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1084 SC Primary

Addresses

Primary practice location

100 Trinity St
Abbeville, SC 29620-2130

Mailing address

100 Trinity St
Abbeville, SC 29620-2130
Phone (864) 366-2020

Other identifiers 2

IdentifierTypeStateIssuer
DA9853MedicaidSC
D10842MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20100929001114 SC Practitioner - Optometry 6709902588 Practice locations: Abbeville, SC

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Trinity St
Abbeville, SC 29620-2130
Phone (864) 459-5108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1084SCMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bowen Family Eyecare, P.a. Optometrist CurrentSince Dec 2, 1997 Accepting new patients

Locations

100 Trinity St
Abbeville, SC 29620
Phone (864) 366-2020

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1104001536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TRINITY ST",
            "city": "ABBEVILLE",
            "state": "SC",
            "postal_code": "296202130",
            "telephone_number": "864-366-2020",
            "fax_number": "864-366-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TRINITY ST",
            "city": "ABBEVILLE",
            "state": "SC",
            "postal_code": "296202130",
            "telephone_number": "864-366-2020",
            "fax_number": "864-366-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "LELAND",
        "middle_name": "HAROLD",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9853",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D10842",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abbeville, SC

Sources for this page

Verify at the official NPI Registry.