Individual provider Active NPI

Jessica Lynn Bowman, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Bearden, AR
National Provider Identifier
1689814709
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP#3175 Issued in AR
Practice address
100 Oak Ave
Bearden, AR 71720-8826
Phone
(870) 687-3503
NPI assigned
Mar 2, 2009
Last updated
Oct 1, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 24777 TX
Speech-Language Pathologist 235Z00000X SP#3175 AR Primary

Addresses

Primary practice location

100 Oak Ave
Bearden, AR 71720-8826

Mailing address

100 Oak Ave
Bearden, AR 71720-8826
Phone (870) 687-3503

Other identifiers 2

IdentifierTypeStateIssuer
111408402MedicaidTX
193377721MedicaidAR

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
Master of Science

State licenses

LicenseStateTypeSpecialty
24777TXMDDental Hygienist
SP#3175ARMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1689814709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 OAK AVE",
            "city": "BEARDEN",
            "state": "AR",
            "postal_code": "717208826",
            "telephone_number": "870-687-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 OAK AVE",
            "city": "BEARDEN",
            "state": "AR",
            "postal_code": "717208826",
            "telephone_number": "870-687-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-02",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "24777",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#3175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111408402",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193377721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bearden, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.