Active NPI
Gerard John Bowen Jr., MHA, ATC
- Athletic Trainer
- Stonewall, LA
National Provider Identifier
1124060264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 2571 Highway 171
Stonewall, LA 71078-9423 - Phone
- (318) 925-6917
- NPI assigned
- Jun 12, 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
2571 Highway 171
Stonewall, LA 71078-9423
Mailing address
6034 Braeburn CT
Bossier City, LA 71111-5746
Phone (318) 549-3421
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276646400000",
"number": "1124060264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6034 BRAEBURN CT",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711115746",
"telephone_number": "318-549-3421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2571 HIGHWAY 171",
"city": "STONEWALL",
"state": "LA",
"postal_code": "710789423",
"telephone_number": "318-925-6917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWEN",
"first_name": "GERARD",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "MHA, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2010-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stonewall, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.