Kellie Marie Bowen, PA-C
Individual provider Active NPI Physician Assistant · Ann Arbor, MI
NPI 1326534348 · NPPES record last updated Nov 13, 2024
Key facts
- NPI
- 1326534348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 5601008787 (MI)
- Practice address
- 1500 E Medical Center Dr
Ann Arbor, MI 48109-5000 - Phone
- (734) 936-4000
- NPI assigned
- Jul 2, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Regents of the University of Michigan
Practice addresses (Care Compare)
1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4000
1801 Briarwood Cir
Ann Arbor, MI 48108-3347
Phone (734) 539-5000
Hospital & facility affiliations
- University of Michigan Health System
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181212001934 | MI | Practitioner - Physician Assistant | 9638413024 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601008787 | MI | MD | Physician Assistant |
| 0010-12392 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Promed Healthcare | Current |
Accepting new patients | |
| Regents of the University of Michigan | Current |
Accepting new patients | |
| Regents of the University of Michigan | Physician Assistant | Current |
Accepting new patients |
| Ascension Medical Group Promed | Current |
Accepting new patients |
Locations
1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280
3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229
1801 Briarwood Cir
Ann Arbor, MI 48108
Phone (734) 539-5000
1500 E Medical Center Dr
#B1
Ann Arbor, MI 48109
Phone (734) 936-4500
3770 Capital Ave SW
Ste C
Battle Creek, MI 49015
Phone (269) 441-1755
1535 Gull Rd
Ste 105
Kalamazoo, MI 49048
Phone (616) 381-1433
7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-12392 | NC | |
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | 5601008787 | MI | Yes |
Addresses
Primary practice location
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Mailing address
3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299
Other practice location 1
3024 New Bern Ave
Raleigh, NC 27610-1247
Phone (919) 350-5318
Other practice location 2
1535 Gull Rd Ste 105
Kalamazoo, MI 49048
Phone (269) 338-5990 ext. 226
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | KGH-DHC@direct.kalamazoogastro.nextgenshare.com | Direct |
Other providers in Ann Arbor, MI
- Grant Bowbeer
- Olen Foss Bowen-Graham
- Ashley Bowen
- Emma Bowen
- Heather Ann Bowen
- Eizabeth Maxine Bower
- Melissa Lee Bower
- Kelly Bowers
- Kristi Robin Bowers
- Pamela Bowers
All providers in Ann Arbor, MI · Physician Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.