Bruce K Bowen, MD
Individual provider Active NPI Family Medicine Physician · Basalt, CO
NPI 1679569479 · NPPES record last updated May 27, 2009
Key facts
- NPI
- 1679569479
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- CO37578 (CO)
- Practice address
- 1450 E Valley Rd
Suite 101
Basalt, CO 81621-8352 - Phone
- (970) 927-1444
- NPI assigned
- Sep 27, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- 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 |
|---|---|---|---|---|
| I20040824000682 | CO | Practitioner - Family Practice | 5294709341 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CO37578 | CO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspen Valley Hospital District | Current |
Accepting new patients | |
| Aspen Valley Hospital District | Current |
Accepting new patients | |
| Aspen Valley Hospital District | Current |
Accepting new patients | |
| Aspen Valley Hospital District Clinics | Past | Accepting new patients |
Locations
401 Castle Creek Rd
Aspen, CO 81611
Phone (970) 544-1192
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | CO37578 | CO | Yes |
Addresses
Primary practice location
1450 E Valley Rd
Suite 101
Basalt, CO 81621-8352
Mailing address
1450 E Valley Rd
Suite 101
Basalt, CO 81621-8304
Phone (970) 927-1444
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09670262 | Medicaid | CO |
Other providers in Basalt, CO
- Erica Belfiore
- Marcus Blue
- Suzanne Bober
- Willa Bonzi
- David J Borchers
- Chelsie R Brehm
- Bryn Lou Brendamour
- Vega Brhely
- Andrew David Brooks
- April Brooks
All providers in Basalt, CO · Family Medicine Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2009. 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.