Bowling Green Dermatology & Skin Cancer Specialists PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

41690 Issued in KY

Legal business name

BOWLING GREEN DERMATOLOGY & SKIN CANCER SPECIALISTS PLLC

Practice address

1106 Fairway Street
Bowling Green, KY 42103

Phone

(615) 672-5953

Fax

(615) 672-5953

NPI assigned

Mar 13, 2008

Last updated

Sep 30, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Davis Cowan, MDNPI 1902080559

Title

Owner

Phone

(615) 672-5953

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GHEFAA

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John David Cowan, MD

  • MOHS-Micrographic Surgery Physician
  • Bowling Green, KY
  • NPI 1902080559

  Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Kristy M Keeney, APRN

  • Nurse Practitioner
  • Bowling Green, KY
  • NPI 1265893622
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222732800000",
    "number": "1609047083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 FAIRWAY STREET",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42103",
            "telephone_number": "615-672-5953",
            "fax_number": "615-672-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 FAIRWAY STREET",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42103",
            "telephone_number": "615-672-5953",
            "fax_number": "615-672-5953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOWLING GREEN DERMATOLOGY & SKIN CANCER SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-09-30",
        "status": "A",
        "authorized_official_last_name": "COWAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DAVIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-672-5953",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "41690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Ashley Bottoms
• Stephanie Bouchard, DO
• Rene Albert Boucher, DO
• Kimberly Dawn Bowen, PT
• Bowling Green Anesthesiology Associates, PSC
• Bowling Green Dialysis Center Inc
• Bowling Green Emergency Services, LLC
• Bowling Green Family Chiropractic PLLC (Bowling Green Family Chiropractic)
• Bowling Green Health Center LLC (Bowling Green Nursing and Rehabilitation Center)
• Bowling Green Health Facilities LP (Bowling Green Nursing and Rehabilitation Center)

• Dermatology Physician in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Dermatology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; 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.