Jeta Laurie Bowman, AGNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP130960 Issued in TX

Practice address

520 Douglas Blvd
Tyler, TX 75702

Phone

(903) 606-1721

NPI assigned

May 20, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbowman136865@christushealth.direct-ci.net

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.

• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225

  TX

  Medicare reassignment Care Compare group NPD
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  Care Compare group NPD
• Kunik Health, PA

  • Internal Medicine Physician
  • Flower Mound, TX
  • NPI 1750550778

  TX

  Medicare reassignment
• Christus Trinity Clinic

  • Durable Medical Equipment & Medical Supplies
  • New Braunfels, TX
  • NPI 1639807548
  Care Compare group
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Emory, TX
  • NPI 1033641105
  Care Compare group
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Canton, TX
  • NPI 1134313083
  Care Compare group
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Mineola, TX
  • NPI 1275727125
  Care Compare group
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Hawkins, TX
  • NPI 1396939146
  Care Compare group
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Quitman, TX
  • NPI 1497949341
  Care Compare group
• Christus Trinity Clinic

  • Durable Medical Equipment & Medical Supplies
  • Shreveport, LA
  • NPI 1891422192
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mother Frances Hospital Regional Health Care Center

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439

  Hospital

  Care Compare affiliation

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christus Trinity Clinic Texas 1,540 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1366899288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 DOUGLAS BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75702",
            "telephone_number": "903-606-1721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 Douglas Blvd",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "75702",
            "country_code": "US",
            "telephone_number": "903-606-1721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "JETA",
        "middle_name": "LAURIE",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-20",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP130960",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP130960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381618302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "P02223408",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "787876",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yullyza Maria Bouza, LPC, NCC
• Billie Ruth Bowen, LICENSED PROFESSIONA
• David Marcos Bowen, M.D.
• Alicia Bowles, PT
• Melissa Bowling
• Katherine E Bowman, AUD
• Vanessa Bowman
• Cody Boyd
• Colette K Boyd
• Deborah L Boyd, DO

• All providers in Tyler, TX
• Adult Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.