NPIMap

Individual provider Active NPI

Roy Thomas Bowden III, DO

  • Internal Medicine Physician
  • Charleston, WV
National Provider Identifier
1174594642
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1668 Issued in WV
Practice address
3701 Maccorkle Ave SE
Charleston, WV 25304-1525
Phone
(304) 720-2345
Fax
(304) 720-2347
NPI assigned
Jan 31, 2006
Last updated
Sep 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1668 WV Primary

Addresses

Primary practice location

3701 Maccorkle Ave SE
Charleston, WV 25304-1525

Mailing address

3701 Maccorkle Ave SE
Charleston, WV 25304-1525
Phone (304) 720-2345

Other identifiers 1

IdentifierTypeStateIssuer
5600478000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040325000356 WV Practitioner - Internal MedicinePractitioner - Emergency Medicine 4789576950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia School of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
THS Physician Partners IncGroup PAC ID 9537316393, 366 clinicians

Practice addresses (Care Compare)

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 414-4800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1668WVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
THS Physician Partners Inc Internal Medicine CurrentSince Sep 9, 2024 Accepting new patients
Community Health Association Past Accepting new patients
Complete Care at Oak Ridge LLC Past Accepting new patients
New Century Medical Observation Services of West Virginia, Inc Past Accepting new patients

Locations

L3539
Columbus, OH 43260
Phone (304) 414-4800

1097 Fledderjohn Rd
Charleston, WV 25314
Phone (304) 345-3627

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Arthur B Hodges Center at Edgewood SummitCharleston, WV, CCN 515193 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 15, 2017
Jun 15, 2017
Complete Care at Oak Ridge LLCCharleston, WV, CCN 515174 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 2021
Jun 1, 2021

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1174594642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041525",
            "telephone_number": "304-720-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041525",
            "telephone_number": "304-720-2345",
            "fax_number": "304-720-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWDEN",
        "first_name": "ROY",
        "middle_name": "THOMAS",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "1668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5600478000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.