Individual provider Active NPI

Amanda Bowen, BSN RN

  • Rehabilitation Registered Nurse
  • Saint Louis, MO
National Provider Identifier
1417756511
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Registered NurseTaxonomy code 163WR0400X
License
2014004805 Issued in MO
Practice address
1 Jefferson Barracks Drive
Building 52, 2N65
Saint Louis, MO 63125
Phone
(314) 901-2328
NPI assigned
Mar 11, 2025
Last updated
Mar 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Registered Nurse 163WR0400X 2014004805 MO Primary

Addresses

Primary practice location

1 Jefferson Barracks Drive
Building 52, 2N65
Saint Louis, MO 63125

Mailing address

607 Waller Ave
Saint Louis, MO 63125-1512
Phone (314) 780-5823

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
2014004805MOMDRehabilitation Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1741651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1417756511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 WALLER AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631251512",
            "telephone_number": "314-780-5823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JEFFERSON BARRACKS DRIVE",
            "address_2": "BUILDING 52, 2N65",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63125",
            "telephone_number": "314-901-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "AMANDA",
        "credential": "BSN RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-11",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "MO",
            "license": "2014004805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.