Individual provider Active NPI

Ashley Anderson Bowker, PA-C

  • Physician Assistant
  • Athens, GA
National Provider Identifier
1578047056
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008964 Issued in GA
Practice address
340 N Milledge Ave Ste B
Athens, GA 30601-3806
Phone
(706) 548-0008
Fax
(706) 369-9673
NPI assigned
Sep 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 008964 GA Primary

Addresses

Primary practice location

340 N Milledge Ave Ste B
Athens, GA 30601-3806

Mailing address

1355 Peachtree St NE Ste 1600
Atlanta, GA 30309-3276
Phone (678) 223-7774

Other practice location 1

1305 Jennings Mill Rd Ste 260
Watkinsville, GA 30677-7204
Phone (706) 548-0008

Other identifiers 1

IdentifierTypeStateIssuer
008964OtherGAGEORGIA MEDICAL LICENSE

Other names 1

  • Ashley Caitlin Anderson Former name

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
008964GAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1578047056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 PEACHTREE ST NE STE 1600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303093276",
            "telephone_number": "678-223-7774",
            "fax_number": "678-223-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 N MILLEDGE AVE STE B",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306013806",
            "telephone_number": "706-548-0008",
            "fax_number": "706-369-9673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1305 Jennings Mill Rd Ste 260",
            "address_purpose": "LOCATION",
            "city": "Watkinsville",
            "state": "GA",
            "postal_code": "306777204",
            "country_code": "US",
            "telephone_number": "706-548-0008",
            "fax_number": "706-369-9673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWKER",
        "first_name": "ASHLEY",
        "middle_name": "ANDERSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "008964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA MEDICAL LICENSE",
            "identifier": "008964",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "ANDERSON",
            "middle_name": "CAITLIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.