Kaitlyn Ann Bowen, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000026684 Issued in MO

Practice address

14653 Clayton Rd
Ballwin, MO 63011-2656

Phone

(314) 415-7535

NPI assigned

Apr 5, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1407597255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 FOREST PKWY APT A",
            "city": "VALLEY PARK",
            "state": "MO",
            "postal_code": "630881008",
            "telephone_number": "217-779-3432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14653 CLAYTON RD",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112656",
            "telephone_number": "314-415-7535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "633 Emerson Rd",
            "address_purpose": "LOCATION",
            "city": "Creve Coeur",
            "state": "MO",
            "postal_code": "631416789",
            "country_code": "US",
            "telephone_number": "341-325-3068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "KAITLYN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2000026684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Michael Bohler
• Adam Robert Bohn, PHARM.D.
• James S. Bonner, M.D.
• Marie A Bosch, MD
• Amelia Helen Bottcher
• Jennifer Bowers, LPC
• Zachary Boyle, DPT
• Brandon Prior DMD LLC
• Brassie Chiropractic LLC
• Joel Andrew Brassie, D.C.

• Athletic Trainer in Ballwin, MO
• Providers in Ballwin, MO by specialty
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.