Active NPI
Keron Bowen
- Occupational Therapist
- Tempe, AZ
National Provider Identifier
1407338254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 51
- Practice address
- 1400 E Southern Ave Ste 310
Tempe, AZ 85282-5695 - Phone
- (602) 567-9881
- NPI assigned
- Aug 29, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 51 | AZ | Primary |
Addresses
Primary practice location
1400 E Southern Ave Ste 310
Tempe, AZ 85282-5695
Mailing address
1640 Redstone Center Dr Ste 200
Park City, UT 84098-7607
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
| License | State | Type | Specialty |
|---|---|---|---|
| 51 | AZ | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535500800000",
"number": "1407338254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1640 REDSTONE CENTER DR STE 200",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840987607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 E SOUTHERN AVE STE 310",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852825695",
"telephone_number": "602-567-9881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWEN",
"first_name": "KERON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-29",
"last_updated": "2018-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "51",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.