Individual provider Active NPI

Rachael Bowen, APRN

  • Family Nurse Practitioner
  • Desoto, TX
National Provider Identifier
1528637006
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1045069 Issued in TX
Practice address
109 Methodist Way
Desoto, TX 75115-1263
Phone
(469) 643-5300
NPI assigned
Jun 21, 2021
Last updated
Jun 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1045069 TX Primary

Addresses

Primary practice location

109 Methodist Way
Desoto, TX 75115-1263

Mailing address

109 Methodist Way
Desoto, TX 75115-1263
Phone (469) 643-5300

Other practice location 1

3020 W Wheatland Rd
Dallas, TX 75237-3537
Phone (972) 708-8600

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210701003042 TX Practitioner - Nurse Practitioner 4587065289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dallas Hospital Consultants PAGroup PAC ID 7810254588, 10 clinicians

Practice addresses (Care Compare)

3020 W Wheatland Rd
Methodist Rehabilitation Hospital
Dallas, TX 75237-3537
Phone (972) 708-8600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1045069TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Hospital Consultants PA CurrentSince Jun 23, 2021 Accepting new patients

Locations

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1528637006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 METHODIST WAY",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751151263",
            "telephone_number": "469-643-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 METHODIST WAY",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751151263",
            "telephone_number": "469-643-5300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3020 W Wheatland Rd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752373537",
            "country_code": "US",
            "telephone_number": "972-708-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "RACHAEL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1045069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

Verify at the official NPI Registry.