NPIMap

Individual provider Active NPI

Kelly Koss Bowlin, D.O.

  • Obstetrics & Gynecology Physician
  • Saint Paul, MN
National Provider Identifier
1477582880
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
51737 Issued in MN
Practice address
205 Wabasha St S
Saint Paul, MN 55107-1805
Phone
(651) 293-8100
Fax
(651) 293-8106
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 51737 MN
Student in an Organized Health Care Education/Training Program 390200000X 2005017750- RESIDENT MO
Obstetrics & Gynecology Physician 207V00000X 51737 MN Primary

Addresses

Primary practice location

205 Wabasha St S
Saint Paul, MN 55107-1805

Mailing address

8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

14000 Fairview Dr
Burnsville, MN 55337-5713
Phone (952) 993-8693

Other names 1

  • Dr. Kelly Marie Bowlin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090917000104 MN Practitioner - Obstetrics/Gynecology 5193871150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

205 Wabasha Ave S
Saint Paul, MN 55107-1805
Phone (651) 227-3757

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2005017750- RESIDENTMOMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Sep 20, 2018 Accepting new patients
Group Health, Inc. Current Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

8170 33rd Ave S
Stop 21110Q
Minneapolis, MN 55425

205 Wabasha St S
Saint Paul, MN 55107
Phone (651) 293-8100

Interoperability endpoints

  • Direct secure messaging: kbowlin150186@direct.healthpartners.com

Organizations & group practices 2

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1477582880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 WABASHA ST S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551071805",
            "telephone_number": "651-293-8100",
            "fax_number": "651-293-8106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14000 Fairview Dr",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553375713",
            "country_code": "US",
            "telephone_number": "952-993-8693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWLIN",
        "first_name": "KELLY",
        "middle_name": "KOSS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MN",
            "license": "51737",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "2005017750- RESIDENT",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "51737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "BOWLIN",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.