John Bowery, DO
Individual provider Active NPI Family Medicine Physician · Shenandoah, IA
NPI 1669565461 · NPPES record last updated Feb 28, 2012
Key facts
- NPI
- 1669565461
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 02434 (IA)
- Practice address
- 300 Pershing Ave
Shenandoah, IA 51601-2355 - Phone
- (712) 374-6005
- Fax
- (712) 374-2301
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040623001510 | IA | Practitioner - Emergency Medicine |
3870584667 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 572 | NV | MD | Optometrist |
| 02434 | IA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shenandoah Medical Center | Current | Accepting new patients | |
| Shenandoah Medical Center | Current | Accepting new patients | |
| Shenandoah Medical Center | Current |
Accepting new patients | |
| Shenandoah Medical Center | Current | Accepting new patients | |
| Shenandoah Medical Center | Current |
Accepting new patients |
Locations
300 Pershing Ave
Shenandoah, IA 51601
Phone (712) 246-1230
Interoperability endpoints
- johnbowery@shenmed.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 02434 | IA | Yes |
Addresses
Primary practice location
300 Pershing Ave
Shenandoah, IA 51601-2355
Mailing address
300 Pershing Ave
Shenandoah, IA 51601-2355
Phone (712) 246-1230
Other providers in Shenandoah, IA
- Tonja Batt
- Jacy Bayless
- Marvin E Belknap
- Darcy J Beltran
- Barbara Ann Boston
- Donald L Bumgarner
- Kimberly Michelle Burns
- Elizabeth Anne Busekist Lord Feil
- Ashley M Cabbage
- Ryan Robert Carlson
All providers in Shenandoah, IA · Family Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.