Active NPI
Myles Bowie
- Physical Therapist
- Fremont, CA
National Provider Identifier
1457695710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 39633
- Practice address
- 2296 Country Dr
Fremont, CA 94536-5315 - Phone
- (510) 797-9299
- Fax
- (510) 795-4739
- NPI assigned
- Nov 26, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 39633 | CA | Primary |
Addresses
Primary practice location
2296 Country Dr
Fremont, CA 94536-5315
Mailing address
2296 Country Dr
Fremont, CA 94536-5315
Phone (510) 797-9299
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130104000370 | CA | Practitioner - Physical Therapist in Private Practice | 8820241581 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39633 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353888000000",
"number": "1457695710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2296 COUNTRY DR",
"city": "FREMONT",
"state": "CA",
"postal_code": "945365315",
"telephone_number": "510-797-9299",
"fax_number": "510-795-4739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2296 COUNTRY DR",
"city": "FREMONT",
"state": "CA",
"postal_code": "945365315",
"telephone_number": "510-797-9299",
"fax_number": "510-795-4739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWIE",
"first_name": "MYLES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-11-26",
"last_updated": "2012-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "39633",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.