Individual provider Active NPI

Steven D. Bowser, O.D.

  • Optometrist
  • Smyrna, GA
National Provider Identifier
1235443839
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002606 Issued in GA
Practice address
4280 E West Connector SE
Smyrna, GA 30082-4804
Phone
(770) 435-4457
NPI assigned
Aug 6, 2010
Last updated
Jan 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002606 GA Primary

Addresses

Primary practice location

4280 E West Connector SE
Smyrna, GA 30082-4804

Mailing address

4022 Watkins Glen Dr
Woodstock, GA 30189-5494
Phone (678) 977-2196

Other identifiers 1

IdentifierTypeStateIssuer
003112800AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101207000195 GA Practitioner - Optometry 2062609811 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smyrna Eye Group, P.C.Group PAC ID 2163403510, 4 clinicians

Practice addresses (Care Compare)

4280 E W Connector SE
Smyrna, GA 30082
Phone (770) 435-4457

4280 E W Connector SE
Smyrna, GA 30082-4804

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT002606GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Smyrna Eye Group, P.C. Optometrist CurrentSince Aug 1, 2011 Accepting new patients

Locations

4280 East West Connector SE
Smyrna, GA 30082
Phone (770) 435-4457

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": "1281052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1235443839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4022 WATKINS GLEN DR",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895494",
            "telephone_number": "678-977-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 E WEST CONNECTOR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300824804",
            "telephone_number": "770-435-4457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWSER",
        "first_name": "STEVEN",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-06",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003112800A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

Verify at the official NPI Registry.