Individual provider Active NPI

Andrea Michelle Bowles, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1225616519
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5928741-4405 Issued in UT
Practice address
1480 N 8000 W
Salt Lake City, UT 84116-3961
Phone
(801) 522-7000
NPI assigned
Mar 30, 2021
Last updated
Jun 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5928741-4405 UT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5928741-4405 UT Primary

Addresses

Primary practice location

1480 N 8000 W
Salt Lake City, UT 84116-3961

Mailing address

429 Gold Dust Rd
Grantsville, UT 84029-5521
Phone (435) 262-6366

Other practice location 1

5965 S 900 E Ste 100
Murray, UT 84121-1850
Phone (801) 639-9146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5928741-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Utah, Department of Health PastSince Apr 1, 2021 Accepting new patients
State of Utah PastSince Apr 1, 2021 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1225616519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 GOLD DUST RD",
            "city": "GRANTSVILLE",
            "state": "UT",
            "postal_code": "840295521",
            "telephone_number": "435-262-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 N 8000 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841163961",
            "telephone_number": "801-522-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5965 S 900 E Ste 100",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "841211850",
            "country_code": "US",
            "telephone_number": "801-639-9146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWLES",
        "first_name": "ANDREA",
        "middle_name": "MICHELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "5928741-4405",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "5928741-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; 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.