Individual provider Active NPI

Kimberly Bowers

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1619422888
Registry record updated Apr 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21576 Issued in TN
Practice address
880 Madison Ave
Memphis, TN 38103-3409
Phone
(901) 515-3800
NPI assigned
Aug 17, 2016
Last updated
Apr 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2024

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 21576 TN Primary

Addresses

Primary practice location

880 Madison Ave
Memphis, TN 38103-3409

Mailing address

PO Box 405827
Atlanta, GA 30384-5827

Other practice location 1

1101 Wilson Blvd Fl 6
Arlington, VA 22209-2281
Phone (888) 731-8994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20160830002503 TN Practitioner - Nurse Practitioner 9032405022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.97 of 100Reported as group
Quality
64.58
Improvement activities
40
Cost
77.33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21576TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Regional One Physicians Inc CurrentSince Sep 22, 2020 Accepting new patients
Ut Regional One Physicians Inc CurrentSince Sep 22, 2020 Accepting new patients
Integrative Womens Care PC Past Accepting new patients

Locations

1588 Union Ave
Memphis, TN 38104
Phone (901) 276-2410

877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893

880 Madison Ave
Memphis, TN 38103
Phone (901) 515-3500

880 Madison Ave
#3
Memphis, TN 38103

7945 Wolf River Blvd
Memphis, TN 38138
Phone (901) 448-7000

6215 Humphreys Blvd
Ste 201
Memphis, TN 38120
Phone (901) 866-8085

Organizations & group practices 3

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": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714262400000",
    "number": "1619422888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 405827",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303845827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033409",
            "telephone_number": "901-515-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Wilson Blvd Fl 6",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222092281",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWERS",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-17",
        "last_updated": "2024-04-28",
        "certification_date": "2024-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.