Jessica A. Bowman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8844-123 Issued in WI

Practice address

571 County Road a
Green Lake, WI 54941-8630

Phone

(920) 294-4070

Fax

(920) 294-4139

NPI assigned

Oct 5, 2016

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 22, 2019.

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1144770959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 COUNTY ROAD A",
            "city": "GREEN LAKE",
            "state": "WI",
            "postal_code": "549418630",
            "telephone_number": "920-294-4070",
            "fax_number": "920-294-4139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 COUNTY ROAD A",
            "city": "GREEN LAKE",
            "state": "WI",
            "postal_code": "549418630",
            "telephone_number": "920-294-4070",
            "fax_number": "920-294-4139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "JESSICA",
        "middle_name": "A.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-05",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8844-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APSW - WISCONSIN STATE BOARD",
            "identifier": "130094-121",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100061173",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• County of Green Lake

• All providers in Green Lake, WI
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.