Individual provider Active NPI

Kailee Bowlden, CNM

  • Advanced Practice Midwife
  • Fayetteville, GA
National Provider Identifier
1376304535
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN274706 Issued in GA
Practice address
1279 Highway 54 W Ste 220
Fayetteville, GA 30214-4552
Phone
(770) 991-2200
Fax
(770) 991-1341
NPI assigned
Jan 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X RN274706 GA Primary

Addresses

Primary practice location

1279 Highway 54 W Ste 220
Fayetteville, GA 30214-4552

Mailing address

1279 Highway 54 W Ste 220
Fayetteville, GA 30214-4552
Phone (770) 991-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260403002646 GA Practitioner - Certified Nurse Midwife (CNM) 8921573213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

619 S 8TH St
Suite 200
Griffin, GA 30224-4260
Phone (770) 227-5505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN274706GAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Crescent Women'S Healthcare PC CurrentSince Jan 21, 2024 Accepting new patients
Women'S Community Care, PC PastSince Jan 21, 2024 Accepting new patients

Locations

1279 Highway 54 W
Ste 220
Fayetteville, GA 30214
Phone (770) 991-2200

619 S 8th St
Ste 200
Griffin, GA 30224
Phone (770) 227-1587

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": "1705363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1376304535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1279 HIGHWAY 54 W STE 220",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144552",
            "telephone_number": "770-991-2200",
            "fax_number": "770-991-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1279 HIGHWAY 54 W STE 220",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144552",
            "telephone_number": "770-991-2200",
            "fax_number": "770-991-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWLDEN",
        "first_name": "KAILEE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "RN274706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.