Individual provider Active NPI

Daniel Bowman, BCABA, LABA

  • Behavior Analyst
  • Fredericksburg, VA
National Provider Identifier
1306507710
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0134000419 Issued in VA
Practice address
417 Chatham Square Office Park
Fredericksburg, VA 22405-2561
Phone
(540) 940-2136
NPI assigned
Jan 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 0134000419 VA Primary

Addresses

Primary practice location

417 Chatham Square Office Park
Fredericksburg, VA 22405-2561

Mailing address

904 Princess Anne St Ste 407
Fredericksburg, VA 22401-5804
Phone (540) 479-3889

Other practice location 1

312 Progress St Ste 300
Fredericksburg, VA 22401-3356
Phone (540) 479-3889

Other practice location 2

4000 Genesee Pl Ste 407
Woodbridge, VA 22192-8302
Phone (540) 479-3889

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
0134000419VAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Autism Services, LLC Behavior Analyst PastSince Jan 17, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1306507710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 PRINCESS ANNE ST STE 407",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224015804",
            "telephone_number": "540-479-3889",
            "fax_number": "540-479-3946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 CHATHAM SQUARE OFFICE PARK",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224052561",
            "telephone_number": "540-940-2136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "312 Progress St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224013356",
            "country_code": "US",
            "telephone_number": "540-479-3889",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Genesee Pl Ste 407",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "VA",
            "postal_code": "221928302",
            "country_code": "US",
            "telephone_number": "540-479-3889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "BCABA, LABA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-07",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0134000419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.

Verify at the official NPI Registry.