Individual provider Active NPI

Kathryn Bowen, MD

  • Pediatrics Physician
  • Tucson, AZ
National Provider Identifier
1124090709
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
18627 Issued in AZ
Practice address
2800 E Ajo Way
Tucson, AZ 85713-6204
Phone
(520) 874-3500
NPI assigned
Feb 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 18627 AZ Primary

Addresses

Primary practice location

2800 E Ajo Way
Tucson, AZ 85713-6204

Mailing address

2701 E Elvira Rd
Tucson, AZ 85706-7124
Phone (520) 874-3500

Other identifiers 2

IdentifierTypeStateIssuer
ZWCGCROtherAZGROUP MEDICARE NUMBER
286858MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100910001100 AZ Practitioner - Pediatric Medicine 3577688787 Reassigns benefits to 1 organization
I20201218000148 TX Practitioner - Pediatric Medicine 3577688787 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18627AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Allied Physicians, LLC CurrentSince Sep 1, 2014 Accepting new patients
Northwest Allied Physicians LLC CurrentSince Sep 1, 2014 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Dec 14, 2020 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Dec 14, 2020 Accepting new patients
Banner-University Medical Group Family Medicine Past Accepting new patients

Locations

8333 N Silverbell Rd
Ste 161
Tucson, AZ 85743
Phone (520) 202-7770

4001 E Sunrise Dr
Ste 121
Tucson, AZ 85718
Phone (520) 209-7000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1124090709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 E ELVIRA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857067124",
            "telephone_number": "520-874-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E AJO WAY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857136204",
            "telephone_number": "520-874-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "KATHRYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "18627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE NUMBER",
            "identifier": "ZWCGCR",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286858",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.