Yolanda P Bowdre, OTRL

Primary specialty

SpecialistTaxonomy code 174400000X

License

OT003773 Issued in GA

Practice address

3752 Preservation Cir
Lilburn, GA 30047-7063

Phone

(770) 866-1794

NPI assigned

Aug 1, 2007

Last updated

Oct 14, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Circle of Life Therapy & Consulting LLC

  • Occupational Therapist
  • Lilburn, GA
  • NPI 1598386682
  Authorized official Same address or phone

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1154511426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3752 PRESERVATION CIR",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300477063",
            "telephone_number": "770-866-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3752 PRESERVATION CIR",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300477063",
            "telephone_number": "770-866-1794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "241 Black Birch Pass",
            "address_purpose": "LOCATION",
            "city": "Lilburn",
            "state": "GA",
            "postal_code": "300477063",
            "country_code": "US",
            "telephone_number": "770-171-5079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWDRE",
        "first_name": "YOLANDA",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "OT003373",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "OT003773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amir Borhanipoor, OD
• Boski R. Amin OD, LLC (Lilburn Family Eye Care)
• Lequisha Monique Bostic
• Diana M Boswell, MCD, CCC
• James Brian Boulware, MA, ATC, OTC, LAT
• Marcus Bradley
• Tonya L Brailey
• Brain and Soul Wellness Group, LLC
• James Palmer Branch, D.P.M
• William George Brandenburg, DDS

• Specialist in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.