Individual provider Active NPI

Jennifer Bowen, PHARMD

  • Pharmacist
  • Meridian, ID
National Provider Identifier
1457760092
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P7802 Issued in ID
Practice address
520 S Eagle Rd
Suite 1000
Meridian, ID 83642-8364
Phone
(208) 706-5252
Fax
(208) 706-5255
NPI assigned
Aug 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X CT1177 ID
Pharmacist 183500000X P7802 ID Primary

Addresses

Primary practice location

520 S Eagle Rd
Suite 1000
Meridian, ID 83642-8364

Mailing address

16700 N Market Place Blvd
Nampa, ID 83687-7909

Other practice location 1

16700 N Market Place Blvd
Nampa, ID 83687-7909
Phone (208) 465-3809

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
P7802IDMDPharmacist
CT1177IDMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Regional Medical Center Past Accepting new patients

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": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1457760092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16700 N MARKET PLACE BLVD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836877909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S EAGLE RD",
            "address_2": "SUITE 1000",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428364",
            "telephone_number": "208-706-5252",
            "fax_number": "208-706-5255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16700 N Market Place Blvd",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836877909",
            "country_code": "US",
            "telephone_number": "208-465-3809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "JENNIFER",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "ID",
            "license": "CT1177",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P7802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.