Individual provider Active NPI

Heather Leigh Bowyer, D.C.

  • Chiropractor
  • Port Orange, FL
National Provider Identifier
1457480477
Registry record updated Apr 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 9640 Issued in FL
Practice address
4705 S Clyde Morris Blvd
Port Orange, FL 32129-4103
Phone
(386) 763-2778
NPI assigned
Mar 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 30526 CA
Chiropractor 111N00000X DC 9640 FL Primary

Addresses

Primary practice location

4705 S Clyde Morris Blvd
Port Orange, FL 32129-4103

Mailing address

28 Zeolite PL
Palm Coast, FL 32164-5229
Phone (386) 263-2145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090908000605 FL Practitioner - Chiropractic 0941355390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmer College FoundationGroup PAC ID 1557266863, 44 clinicians

Practice addresses (Care Compare)

4705 Clyde Morris Blvd
Port Orange, FL 32129-4103
Phone (386) 763-2718

4705 S Clyde Morris Blvd
Port Orange, FL 32129-4103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC 9640FLMDChiropractor

Organizations & group practices 1

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": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302220800000",
    "number": "1457480477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 ZEOLITE PL",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645229",
            "telephone_number": "386-263-2145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 S CLYDE MORRIS BLVD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294103",
            "telephone_number": "386-763-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWYER",
        "first_name": "HEATHER",
        "middle_name": "LEIGH",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2011-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "30526",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "DC 9640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.