Individual provider Active NPI

Jade Madison Bowman, MD

  • General Practice Physician
  • Fairfield, CA
National Provider Identifier
1104696236
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A204748 Issued in CA
Practice address
101 Bodin Cir
Fairfield, CA 94535-1809
Phone
(707) 423-5349
NPI assigned
Jan 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A204748 CA Primary

Addresses

Primary practice location

101 Bodin Cir
Fairfield, CA 94535-1809

Mailing address

101 Bodin Cir
Fairfield, CA 94535-1809

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250909003903 CA Order and Referring Only - Family PracticePractitioner - Family Practice 2961905781

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A204748CAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1704758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1104696236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945351809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-5349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "JADE",
        "middle_name": "MADISON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-09",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A204748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.