Individual provider Active NPI

Tamara L Bowling, FNP-C

  • Family Nurse Practitioner
  • Wadsworth, OH
National Provider Identifier
1134569478
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA.14688-NP Issued in OH
Practice address
230 Quadral Dr
Ste B
Wadsworth, OH 44281-8376
Phone
(330) 336-2800
NPI assigned
Jul 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA.14688-NP OH Primary

Addresses

Primary practice location

230 Quadral Dr
Ste B
Wadsworth, OH 44281-8376

Mailing address

6995 Fairhaven Oval Dr
Medina, OH 44256-6384
Phone (724) 494-6482

Other identifiers 2

IdentifierTypeStateIssuer
0088065MedicaidOH
COA.14688-NPOtherOHLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NC, OR3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20130820000257 OH Practitioner - Nurse Practitioner 7113169244 Reassigns benefits to 1 organization
I20241118000411 NC Practitioner - Nurse Practitioner 7113169244 Reassigns benefits to 1 organization
I20250714001501 OR Practitioner - Nurse Practitioner 7113169244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boulder Care Provider Group PAGroup PAC ID 6901217447, 115 clinicians

Practice addresses (Care Compare)

106 Langtree Village Dr
Suite 301
Mooresville, NC 28117-7594
Phone (888) 288-4715

111 SW Naito Pkwy
Suite 200
Portland, OR 97204-3512
Phone (503) 563-7370

20046 Walker Rd
Suite 7
Shaker Heights, OH 44122-3645
Phone (503) 208-5061

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.14688-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Care Provider Group PA CurrentSince Nov 1, 2024 Accepting new patients
Eleanor Health Professional Oh, LLC CurrentSince Dec 2, 2021 Accepting new patients
Cornerstone Psychological & Counseling Services of Northeast Ohio PastSince Apr 1, 2020 Accepting new patients

Locations

106 Langtree Village Dr
Ste 301
Mooresville, NC 28117
Phone (704) 457-1368

789 White Pond Dr
Ste C
Akron, OH 44320
Phone (330) 355-3153

20046 Walker Rd
Ste 7
Shaker Heights, OH 44122
Phone (503) 208-5061

25 N Canfield Niles Rd
Ste 30
Youngstown, OH 44515
Phone (330) 355-3153

111 SW Naito Pkwy
Ste 200
Portland, OR 97204
Phone (503) 208-5061

Organizations & group practices 3

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": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1134569478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6995 FAIRHAVEN OVAL DR",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442566384",
            "telephone_number": "724-494-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 QUADRAL DR",
            "address_2": "STE B",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818376",
            "telephone_number": "330-336-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWLING",
        "first_name": "TAMARA",
        "middle_name": "L",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-01",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.14688-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0088065",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "COA.14688-NP",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadsworth, OH

Sources for this page

Verify at the official NPI Registry.