Individual provider Active NPI

Martha Michelle Bowden, M.D.

  • Pediatric Adolescent Medicine Physician
  • Memphis, TN
National Provider Identifier
1730524216
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
54014 Issued in TN
Practice address
51 N Dunlap St
Ste. 350
Memphis, TN 38105-4625
Phone
(901) 287-7337
NPI assigned
May 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 54014 TN
Pediatric Adolescent Medicine Physician 2080A0000X 54014 TN Primary

Addresses

Primary practice location

51 N Dunlap St
Ste. 350
Memphis, TN 38105-4625

Mailing address

850 Poplar Ave BLDG 2
Memphis, TN 38105-4607
Phone (901) 287-5674

Other names 1

  • Martha Michelle Roark Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161010000501 TN Practitioner - General PracticePractitioner - Emergency MedicinePractitioner - Pediatric Medicine 7517255417 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Lebonheur Pediatric Specialists, Inc. CurrentSince Jul 15, 2017 Accepting new patients

Locations

850 Poplar Ave
Bldg 2
Memphis, TN 38105
Phone (901) 287-5594

100 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 747-1800

848 Adams Ave
Memphis, TN 38103
Phone (901) 287-5437

1407 Union Ave
Ste 200
Memphis, TN 38104
Phone (901) 866-8360

Interoperability endpoints

  • Direct secure messaging: mbowden30099@mlh.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1730524216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 POPLAR AVE BLDG 2",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381054607",
            "telephone_number": "901-287-5674",
            "fax_number": "901-287-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N DUNLAP ST",
            "address_2": "STE. 350",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381054625",
            "telephone_number": "901-287-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWDEN",
        "first_name": "MARTHA",
        "middle_name": "MICHELLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-09",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "54014",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "TN",
            "license": "54014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "ROARK",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.