Active NPI
Matthew Williams Bowen, PHD
- Clinical Neuropsychologist
- Charlottesville, VA
National Provider Identifier
1700825239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 0810003577
- Practice address
- 6 Old Farm Rd
Charlottesville, VA 22903-4722 - Phone
- (434) 962-4720
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 0810003577 | VA | Primary |
Addresses
Primary practice location
6 Old Farm Rd
Charlottesville, VA 22903-4722
Mailing address
6 Old Farm Rd
Charlottesville, VA 22903-4722
Phone (434) 962-4720
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061222000005 | VA | Practitioner - Psychologist Billing Independently | 2062412091 | Practice locations: Charlottesville, VA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1987
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
6 Old Farm Rd
Charlottesville, VA 22903-4722
Phone (434) 962-4720
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373932800000",
"number": "1700825239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 OLD FARM RD",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229034722",
"telephone_number": "434-962-4720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 OLD FARM RD",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229034722",
"telephone_number": "434-962-4720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWEN",
"first_name": "MATTHEW",
"middle_name": "WILLIAMS",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2013-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "VA",
"license": "0810003577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlottesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.