Individual provider Active NPI

Dana Bowersock, SLP

  • Speech-Language Pathologist
  • Albuquerque, NM
National Provider Identifier
1730225533
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3226 Issued in NM
Practice address
5701 Mojave St NW
Maria Hughes Es
Albuquerque, NM 87120-3032
Phone
(505) 897-3080
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3226 NM Primary

Addresses

Primary practice location

5701 Mojave St NW
Maria Hughes Es
Albuquerque, NM 87120-3032

Mailing address

5701 Mojave St NW
Maria Hughes Es
Albuquerque, NM 87120-3032
Phone (505) 897-3080

Other identifiers 1

IdentifierTypeStateIssuer
K 6084MedicaidNM

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1730225533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 MOJAVE ST NW",
            "address_2": "MARIA HUGHES ES",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871203032",
            "telephone_number": "505-897-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 MOJAVE ST NW",
            "address_2": "MARIA HUGHES ES",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871203032",
            "telephone_number": "505-897-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWERSOCK",
        "first_name": "DANA",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "3226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K 6084",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.