Individual provider Active NPI

Mary Bowman, PT, DPT,OCS,LMT

  • Physical Therapist
  • Corydon, IN
National Provider Identifier
1487959482
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05010942A Issued in IN
Practice address
2363 Highway 135 NW
117
Corydon, IN 47112-2153
Phone
(812) 734-1918
NPI assigned
Jan 21, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 005747 KY
Physical Therapist 225100000X 05010942A IN Primary

Addresses

Primary practice location

2363 Highway 135 NW
117
Corydon, IN 47112-2153

Mailing address

3689 Melissa CT NW
Corydon, IN 47112-6277
Phone (812) 972-0877

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170131002345 IN Practitioner - Physical Therapist in Private Practice 2961784731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SN Kentuckiana Rehab, LLCGroup PAC ID 1254671464, 339 clinicians

Practice addresses (Care Compare)

173 Pacer Dr NW
Corydon, IN 47112-2144
Phone (812) 734-1918

325 E Lewis and Clark Pkwy
Suite 100
Clarksville, IN 47129-1725
Phone (812) 283-3231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005747KYMDPhysical Therapy Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
SN Kentuckiana Rehab, LLC Physical Therapy CurrentSince Apr 1, 2019 Accepting new patients
SN Kentuckiana Rehab, LLC Physical Therapy CurrentSince Apr 1, 2019 Accepting new patients
SN Kentuckiana Rehab, LLC Physical Therapy Current Accepting new patients
Select Employment Services, Inc. Past Accepting new patients

Locations

325 E Lewis and Clark Pkwy
Ste 100
Clarksville, IN 47129
Phone (812) 283-3231

173 Pacer Dr NW
Ste 117
Corydon, IN 47112

2363 Highway 135 NW
Ste 117
Corydon, IN 47112
Phone (812) 734-1918

1050 Copperfield Dr
Georgetown, IN 47122
Phone (812) 651-1440

1730 Williamsburg Dr
Ste 3
Jeffersonvlle, IN 47130
Phone (812) 246-0705

3626 Grant Line Rd
Ste 105
New Albany, IN 47150
Phone (502) 558-2903

Organizations & group practices 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1295568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1487959482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3689 MELISSA CT NW",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471126277",
            "telephone_number": "812-972-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2363 HIGHWAY 135 NW",
            "address_2": "117",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471122153",
            "telephone_number": "812-734-1918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT,OCS,LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-21",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "KY",
            "license": "005747",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05010942A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corydon, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; 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.