Individual provider Active NPI

Shannon Abel Bowles, R.N.

  • Registered Nurse
  • Joliet, IL
National Provider Identifier
1679012645
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041405873 Issued in IL
Practice address
4813 Frank Dr
Joliet, IL 60404-9635
Phone
(325) 387-8100
NPI assigned
Feb 23, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041405873 IL Primary

Addresses

Primary practice location

4813 Frank Dr
Joliet, IL 60404-9635

Mailing address

3371 Knickerbocker Rd # 21
San Angelo, TX 76904-6814
Phone (325) 387-8100

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041405873ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1487808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487808000000",
    "number": "1679012645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3371 KNICKERBOCKER RD # 21",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046814",
            "telephone_number": "325-387-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4813 FRANK DR",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604049635",
            "telephone_number": "325-387-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWLES",
        "first_name": "SHANNON",
        "middle_name": "ABEL",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-23",
        "last_updated": "2017-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041405873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; 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.