Individual provider Active NPI

Gemma V Bowerman, FNP

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1447560321
Registry record updated Jul 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3756 Issued in AZ
Practice address
2355 N Wyatt Dr
Suite 101
Tucson, AZ 85712-2120
Phone
(520) 616-4948
Fax
(520) 616-4958
NPI assigned
Oct 13, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 132854 AZ
Family Nurse Practitioner 363LF0000X 3756 AZ Primary

Addresses

Primary practice location

2355 N Wyatt Dr
Suite 101
Tucson, AZ 85712-2120

Mailing address

PO Box 188
Marana, AZ 85653-0188
Phone (520) 682-4111

Other identifiers 1

IdentifierTypeStateIssuer
568360MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20110110000376 AZ Practitioner - Nurse Practitioner 0345439121

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
132854AZMDRegistered Nurse
3756AZMDProcedural Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catalina Hospice PLLC PastSince Sep 20, 2020 Accepting new patients
Marana Health Center, Inc Past Accepting new patients
Agape Hospice & Palliative Care, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: gemma.bowerman.1@30710.direct.athenahealth.com
  • Direct secure messaging: gemma.bowerman.p4@direct.caremorewest.nextgenshare.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1447560321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530188",
            "telephone_number": "520-682-4111",
            "fax_number": "520-682-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 N WYATT DR",
            "address_2": "SUITE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122120",
            "telephone_number": "520-616-4948",
            "fax_number": "520-616-4958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWERMAN",
        "first_name": "GEMMA",
        "middle_name": "V",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-13",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "132854",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "3756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "568360",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.