Individual provider Active NPI

Charon Bowden

  • Pharmacist
  • Atlanta, GA
National Provider Identifier
1700427374
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
024104 Issued in GA
Practice address
3695 Cascade Rd SW
Atlanta, GA 30331-2173
Phone
(404) 505-2876
NPI assigned
Oct 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 024104 GA Primary

Addresses

Primary practice location

3695 Cascade Rd SW
Atlanta, GA 30331-2173

Mailing address

3695 Cascade Rd SW
Atlanta, GA 30331-2173
Phone (404) 505-2876

Other identifiers 1

IdentifierTypeStateIssuer
NOTAPPLICABLEMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL 3695cascaderd

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

NPI Registry JSON

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1700427374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3695 CASCADE RD SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303312173",
            "telephone_number": "404-505-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3695 CASCADE RD SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303312173",
            "telephone_number": "404-505-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWDEN",
        "first_name": "CHARON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "024104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NOTAPPLICABLE",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "3695cascaderd",
            "affiliation": "N",
            "address_1": "3695 Cascade Rd SW",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303312173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.