Mary Kathryn Bowen, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD42989 Issued in IA

Practice address

905 Franklin St
Waterloo, IA 50703-4407

Phone

(319) 272-4300

Fax

(319) 272-4411

NPI assigned

Aug 5, 2008

Last updated

Apr 30, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pine Ridge Indian Health Service Hospital

  dba Pine Ridge IHS Hospital

  • General Acute Care Hospital
  • Pine Ridge, SD
  • NPI 1497786412

  TX

  Medicare reassignment NPD
• Pine Ridge Indian Health Service Hospital

  dba LaCreek District Clinic

  • Clinic/Center
  • Martin, SD
  • NPI 1003208257
  NPD
• Pine Ridge Indian Health Service Hospital

  dba Wanblee Health Center

  • Clinic/Center
  • Wanblee, SD
  • NPI 1962559518
  NPD

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1497911838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 FRANKLIN ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507034407",
            "telephone_number": "319-874-3000",
            "fax_number": "319-874-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 FRANKLIN ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507034407",
            "telephone_number": "319-272-4300",
            "fax_number": "319-272-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-05",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2012001377",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "16195",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "MD42989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076372",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberlee Kay Borneman, C.N.M.
• Kelsey Bothwell
• Rhonda Bottke, ARNP
• Cara Beth Boubin, CADC
• Brian Lee Bouck, DDS
• Kathi K Bower, ARNP
• Dieter J Boxmann, ARNP
• Blue Gregory Boyer, BA, CADC
• Boyle Counseling & Consulting LLC
• Cynthia Renee Boyle, L.M.H.C., N.C.C.

• Pediatrics Physician in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Pediatrics Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.