Derrick Bowling, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME132532 Issued in FL

Practice address

3516 NE 12TH Ave
Oakland Park, FL 33334-4524

Phone

(954) 459-5487

Fax

(954) 530-9774

NPI assigned

Aug 10, 2005

Last updated

Apr 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL, FL2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Derrick Bowling MD PA

  • Primary Care Clinic/Center
  • Oakland Park, FL
  • NPI 1770118655
  Authorized official Same address or phone
• Dwic of Tampa Bay, Inc

  dba MedExpress Urgent Care - Hudson, State Road 52

  • Urgent Care Clinic/Center
  • Hudson, FL
  • NPI 1598132490
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• HMC Rural Health Clinic LLC

  • Family Medicine Physician
  • Jasper, AL
  • NPI 1174525950
  NPD (past)
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1184626277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3516 NE 12TH AVE",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333344524",
            "telephone_number": "954-459-5487",
            "fax_number": "954-530-9774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3516 NE 12TH AVE",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333344524",
            "telephone_number": "954-459-5487",
            "fax_number": "954-530-9774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWLING",
        "first_name": "DERRICK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "00025470",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "16-320",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME132532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009984025",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jahan Ara Bokhari
• Robyn Bolgla, MSPT
• John W Booher, P.A.
• Pearl Elizabeth Bouie
• Marc Bourassa, HAS
• Bowtie USA Vip Service LLC
• Tenaezha Boyd
• Bradley P Gerhard DC PA (Gerhard Chiropractic Center)
• Timothy Raymond Braga, APRN
• Paula K Braman, LMHC

• Family Medicine Physician in Oakland Park, FL
• Providers in Oakland Park, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.