Individual provider Active NPI

Derek Neil Bowers, ACNP-BC

  • Acute Care Nurse Practitioner
  • Portland, OR
National Provider Identifier
1417284175
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
201150020NP Issued in OR
Practice address
2836 NE Bryce St
Portland, OR 97212-1640
Phone
(615) 330-2032
NPI assigned
Nov 17, 2009
Last updated
Jun 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 14568 TN
Acute Care Nurse Practitioner 363LA2100X 201150020NP OR Primary

Addresses

Primary practice location

2836 NE Bryce St
Portland, OR 97212-1640

Mailing address

2836 NE Bryce St
Portland, OR 97212-1640
Phone (615) 330-2032

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201117001283 TX Practitioner - Nurse Practitioner 3274669270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seton Family of DoctorsGroup PAC ID 0941333280, 785 clinicians

Practice addresses (Care Compare)

1500 Red River St
Austin, TX 78701-1918
Phone (512) 324-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
14568TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Family of Doctors CurrentSince Sep 7, 2020 Accepting new patients
Seton Family of Doctors Current Accepting new patients
Seton Family of Doctors CurrentSince Sep 7, 2020 Accepting new patients

Locations

1400 N Interstate 35
Ste 300
Austin, TX 78701
Phone (512) 324-8300

1500 Red River St
Austin, TX 78701
Phone (512) 324-0150

1601 Trinity St
Ste 704F
Austin, TX 78712
Phone (512) 324-7873

1601 Trinity St
Stop 704
Austin, TX 78712
Phone (512) 324-7468

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

Interoperability endpoints

  • Direct secure messaging: derek.bowers.1@8363.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1417284175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2836 NE BRYCE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972121640",
            "telephone_number": "615-330-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2836 NE BRYCE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972121640",
            "telephone_number": "615-330-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWERS",
        "first_name": "DEREK",
        "middle_name": "NEIL",
        "name_prefix": "Mr.",
        "credential": "ACNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-17",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "14568",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OR",
            "license": "201150020NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.