Active NPI
Jessica Misty Bowab, COTA, CHW, DOULA
- Doula
- Virginia Beach, VA
National Provider Identifier
1275066052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Doula
- Practice address
- 5589 Greenwich Rd
Virginia Beach, VA 23462-6565 - Phone
- (757) 401-4435
- NPI assigned
- Apr 7, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Lactation Consultant (Non-RN) | 174N00000X | |||
| Occupational Therapy Assistant | 224Z00000X | 212675 | TX | |
| Doula | 374J00000X | Primary |
Addresses
Primary practice location
5589 Greenwich Rd
Virginia Beach, VA 23462-6565
Mailing address
1209 Claytor CT
Chesapeake, VA 23320-8183
Phone (915) 276-0881
Other practice location 1
3465 McNutt Rd
Sunland Park, NM 88063-9056
Phone (575) 915-1338
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 212675 | TX | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648425600000",
"number": "1275066052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1209 CLAYTOR CT",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233208183",
"telephone_number": "915-276-0881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5589 GREENWICH RD",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234626565",
"telephone_number": "757-401-4435"
}
],
"practiceLocations": [
{
"address_1": "3465 McNutt Rd",
"address_purpose": "LOCATION",
"city": "Sunland Park",
"state": "NM",
"postal_code": "880639056",
"country_code": "US",
"telephone_number": "575-915-1338",
"fax_number": "575-915-1819",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOWAB",
"first_name": "JESSICA",
"middle_name": "MISTY",
"credential": "COTA, CHW, DOULA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-07",
"last_updated": "2022-03-28",
"certification_date": "2022-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": null,
"license": null,
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TX",
"license": "212675",
"primary": false
},
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.