Thomas Michael Bousman, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

011001605 Issued in VA

Practice address

1133 First Colonial Rd
Virginia Beach, VA 23454-2402

Phone

(757) 496-2050

Fax

(757) 689-4357

NPI assigned

Sep 16, 2010

Sex

Male

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

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.bousman.1@1684.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/1684/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gershon Pain Specialists, LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Virginia Beach, VA
  • NPI 1871710798
  Medicare reassignment
• Gershon Pain Specialists, LLC

  • Durable Medical Equipment & Medical Supplies
  • Virginia Beach, VA
  • NPI 1760755847
  NPD

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1437467115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 FIRST COLONIAL RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542402",
            "telephone_number": "757-496-2050",
            "fax_number": "757-689-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 FIRST COLONIAL RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542402",
            "telephone_number": "757-496-2050",
            "fax_number": "757-689-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUSMAN",
        "first_name": "THOMAS",
        "middle_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-16",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "011001605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Bouldin, PHARMD
• Boulevard Medical Center Inc.
• Jennifer Boulware, SLPA
• Boundless Inc
• Kevin B Bounds, M.D.
• Jessica Misty Bowab, COTA, CHW, DOULA
• Hunter Ashley Bowen
• Kenneth Terrell Bowen, B.S.
• Lauren Goldberg Bowen
• Kimaka Bowens

• Physician Assistant in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; 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.