Organization Active NPI

Melissa Bowman OD Inc

  • Optometrist
  • Cincinnati, OH
National Provider Identifier
1104155035
Registry record updated Feb 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5375 Issued in OH
Legal business name
MELISSA BOWMAN OD INC
Practice address
11919 Montgomery Rd
Cincinnati, OH 45249-2019
Phone
(513) 583-8970
Fax
(513) 583-9072
NPI assigned
Dec 24, 2009
Reactivated
Feb 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2013

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

Authorized official

Name
Dr. Melissa Bowman, ODNPI 1790821791
Title
President
Phone
(513) 583-8970

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 5375 OH Primary

Addresses

Primary practice location

11919 Montgomery Rd
Cincinnati, OH 45249-2019

Mailing address

11919 Montgomery Rd
Cincinnati, OH 45249-2019
Phone (513) 583-8970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100219000694 OH Part B Supplier - Clinic/Group Practice 8224004130 Receives reassigned benefits from 1 practitioner
Practice locations: Montgomery, OH

National Provider Directory

National Provider Directory

Locations

11919 Montgomery Rd
Cincinnati, OH 45249
Phone (513) 583-8970

441 Vine St
#1C
Cincinnati, OH 45202
Phone (513) 721-6790

9897 Montgomery Rd
Montgomery, OH 45242
Phone (513) 583-8970

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1261612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360800000000",
    "number": "1104155035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11919 MONTGOMERY RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452492019",
            "telephone_number": "513-583-8970",
            "fax_number": "513-583-9072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11919 MONTGOMERY RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452492019",
            "telephone_number": "513-583-8970",
            "fax_number": "513-583-9072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA BOWMAN OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-24",
        "last_updated": "2013-02-14",
        "deactivation_date": "2013-01-08",
        "reactivation_date": "2013-02-14",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-583-8970",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.