Organization Active NPI

Brent J. Bowen, M.D.P.C.

  • Legal Medicine
  • Salt Lake City, UT
National Provider Identifier
1710152228
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
173000000X Issued in UT
Legal business name
BRENT J. BOWEN, M.D.P.C.
Practice address
5250 Commerce Dr
Suite 200
Salt Lake City, UT 84107-7926
Phone
(801) 314-2362
Fax
(801) 314-2413
NPI assigned
Apr 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Authorized official

Name
Mrs. Patricia Susan Forbes
Title
Office Manager
Phone
(801) 314-2362

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193400000X SINGLE SPECIALTY GROUP 173000000X 173000000X UT Primary

Addresses

Primary practice location

5250 Commerce Dr
Suite 200
Salt Lake City, UT 84107-7926

Mailing address

5250 Commerce Dr
Suite 200
Salt Lake City, UT 84107-7926
Phone (801) 314-2362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080605000048 UT Part B Supplier - Clinic/Group Practice 8729181334 Receives reassigned benefits from 3 practitioners
Practice locations: Murray, UT; Riverton, UT; Sandy, UT

National Provider Directory

National Provider Directory

Locations

5250 S Commerce Dr
Ste 200
Salt Lake City, UT 84107
Phone (801) 269-2830

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1710152228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 COMMERCE DR",
            "address_2": "SUITE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841077926",
            "telephone_number": "801-314-2362",
            "fax_number": "801-314-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 COMMERCE DR",
            "address_2": "SUITE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841077926",
            "telephone_number": "801-314-2362",
            "fax_number": "801-314-2413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT J. BOWEN, M.D.P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "FORBES",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "SUSAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "801-314-2362",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "UT",
            "license": "173000000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.