Individual provider Active NPI

Donna Bowen-Mortlock

  • Hemodialysis Registered Nurse
  • Sunrise, FL
National Provider Identifier
1366335879
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hemodialysis Registered NurseTaxonomy code 163WH0500X
License
9449444 Issued in FL
Practice address
11911 NW 34TH PL
Sunrise, FL 33323-1235
Phone
(954) 224-3217
NPI assigned
Jun 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hemodialysis Registered Nurse 163WH0500X 9449444 FL Primary

Addresses

Primary practice location

11911 NW 34TH PL
Sunrise, FL 33323-1235

Mailing address

11911 NW 34TH PL
Sunrise, FL 33323-1235
Phone (954) 224-3217

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
9449444FLMDHemodialysis Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1366335879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11911 NW 34TH PL",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333231235",
            "telephone_number": "954-224-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11911 NW 34TH PL",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333231235",
            "telephone_number": "954-224-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN-MORTLOCK",
        "first_name": "DONNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hemodialysis",
            "state": "FL",
            "license": "9449444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; 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.