Active NPI
Richard Lee Bowling, PA
- Physician Assistant
- Sacramento, CA
National Provider Identifier
1114007085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA17669
- Practice address
- 3939 J St
Ste. 370
Sacramento, CA 95819-3631 - Phone
- (916) 453-2800
- Fax
- (916) 453-2804
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA17669 | CA | Primary |
Addresses
Primary practice location
3939 J St
Ste. 370
Sacramento, CA 95819-3631
Mailing address
3939 J St
Ste. 370
Sacramento, CA 95819-3631
Phone (916) 453-2800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00AX58571 | Medicaid | CA | |
| ZZZ05946Z | Other | GROUP PTAN |
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- rbowling11509@hpmg.direct-ci.net
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 and National Provider Directory roles.
-
- Primary Care Clinic/Center
- Folsom, CA
- NPI 1710348321
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208390400000",
"number": "1114007085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3939 J ST",
"address_2": "STE. 370",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958193631",
"telephone_number": "916-453-2800",
"fax_number": "916-453-2804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3939 J ST",
"address_2": "STE. 370",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958193631",
"telephone_number": "916-453-2800",
"fax_number": "916-453-2804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWLING",
"first_name": "RICHARD",
"middle_name": "LEE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2008-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA17669",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00AX58571",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP PTAN",
"identifier": "ZZZ05946Z",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.