Mark Matthew Bowman, DDS MSD INC.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

20639 Issued in OH

Practice address

3637 Medina Rd
Suite 215
Medina, OH 44256-8154

Phone

(330) 722-6884

Fax

(330) 722-0575

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

No

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

Enrolled in OH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331510400000",
    "number": "1417067430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3637 MEDINA RD",
            "address_2": "SUITE 215",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568154",
            "telephone_number": "330-722-6884",
            "fax_number": "330-722-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3637 MEDINA RD",
            "address_2": "SUITE 215",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568154",
            "telephone_number": "330-722-6884",
            "fax_number": "330-722-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "MARK",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DDS MSD INC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "20639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bounce Back Physical Therapy LLC
• Carol Bowen
• Kim D Bowen, MD
• Renee Bowles, LPN
• Dean Arthur Bowman, RN
• Jill Boxler, LSW
• Elizabeth Sue Boyer, LSW
• Shannon Boykin
• Dawn M Boyle, CNP
• Erin Margaret Boyle, COTA/L

• Periodontics in Medina, OH
• Providers in Medina, OH by specialty
• Periodontics in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.