Individual provider Active NPI

Ronnie Durrell Bowen, M.D

  • Family Medicine Physician
  • Memphis, TN
National Provider Identifier
1316966724
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38708 Issued in TN
Practice address
3699 Riverdale Rd
Memphis, TN 38115-5322
Phone
(190) 136-5962
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 38708 TN
Family Medicine Physician 207Q00000X 38708 TN Primary

Addresses

Primary practice location

3699 Riverdale Rd
Memphis, TN 38115-5322

Mailing address

7296 Rourke Cir
Memphis, TN 38125-4823
Phone (901) 756-1248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041207000244 TN Practitioner - Family Practice 5597721092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Meharry Medical College School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3699 Riverdale Rd
Memphis, TN 38115-5322
Phone (901) 365-9625

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Families First Health Care CurrentSince Sep 6, 2006 Accepting new patients
Tennessee Em-I Medical Services, PC Past Accepting new patients
My Doctors Medical Group, PLLC PastSince Sep 6, 2006 Accepting new patients

Locations

3699 Riverdale Rd
Memphis, TN 38115
Phone (901) 365-9625

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GECGDD

Organizations & group practices 3

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1316966724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7296 ROURKE CIR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381254823",
            "telephone_number": "901-756-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3699 RIVERDALE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381155322",
            "telephone_number": "190-136-5962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "RONNIE",
        "middle_name": "DURRELL",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TN",
            "license": "38708",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "38708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.