Individual provider Active NPI

Rebecca J Bowers, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Greenville, SC
National Provider Identifier
1366720369
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
2837584 Issued in SC
Practice address
4006 E North St
Ste C
Greenville, SC 29615-6206
Phone
(864) 417-5255
NPI assigned
Jul 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 37584 SC
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 2837584 SC Primary

Addresses

Primary practice location

4006 E North St
Ste C
Greenville, SC 29615-6206

Mailing address

1307 Hartness Dr
Greenville, SC 29615-5489
Phone (864) 417-5255

Other identifiers 1

IdentifierTypeStateIssuer
375846MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20150811005211 SC Practitioner - Osteopathic Manipulative MedicinePractitioner - Family Practice 7517272115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

37 Villa Rd
Suite 313
Greenville, SC 29615-3038
Phone (864) 417-5255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2837584SCMDNeuromusculoskeletal Medicine & OMM Physician
37584SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fulcrum Osteopathic Wellness, LLC CurrentSince Jul 2, 2016 Accepting new patients

Locations

37 Villa Rd
Ste 313
Greenville, SC 29615
Phone (864) 417-5255

4006 E North St
Ste C
Greenville, SC 29615
Phone (864) 326-4696

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": "1311638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1366720369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 HARTNESS DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296155489",
            "telephone_number": "864-417-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4006 E NORTH ST",
            "address_2": "STE C",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156206",
            "telephone_number": "864-417-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWERS",
        "first_name": "REBECCA",
        "middle_name": "J",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-26",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "37584",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "SC",
            "license": "2837584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375846",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.