Active NPI
Katelin Bowater
- Registered Dietitian
- Jacksonville, FL
National Provider Identifier
1619389673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND5997
- Practice address
- 655 W 8TH St
Jacksonville, FL 32209-6511 - Phone
- (904) 244-0411
- NPI assigned
- May 27, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | ND5997 | FL | Primary |
Addresses
Primary practice location
655 W 8TH St
Jacksonville, FL 32209-6511
Mailing address
1207 Arden Way
Jacksonville Beach, FL 32250-3768
Phone (772) 473-2586
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND5997 | FL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401148800000",
"number": "1619389673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1207 ARDEN WAY",
"city": "JACKSONVILLE BEACH",
"state": "FL",
"postal_code": "322503768",
"telephone_number": "772-473-2586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "655 W 8TH ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322096511",
"telephone_number": "904-244-0411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWATER",
"first_name": "KATELIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-27",
"last_updated": "2014-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND5997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.