Individual provider Active NPI

Mollie Maria Bowman

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1306464425
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F07200208 Issued in GA
Practice address
3240 N E Expy NE
Atlanta, GA 30341-4003
Phone
(404) 480-9330
NPI assigned
Jul 7, 2020
Last updated
May 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F07200208 GA Primary

Addresses

Primary practice location

3240 N E Expy NE
Atlanta, GA 30341-4003

Mailing address

3240 N E Expy NE
Atlanta, GA 30341-4003

Other practice location 1

2165 Prestwick Ct NE
Brookhaven, GA 30319-4083
Phone (845) 527-1583

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

LicenseStateTypeSpecialty
F07200208GAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1306464425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 N E EXPY NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303414003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 N E EXPY NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303414003",
            "telephone_number": "404-480-9330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2165 Prestwick Ct NE",
            "address_purpose": "LOCATION",
            "city": "Brookhaven",
            "state": "GA",
            "postal_code": "303194083",
            "country_code": "US",
            "telephone_number": "845-527-1583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "MOLLIE",
        "middle_name": "MARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-07",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F07200208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.