Kristen Diane Bowdern

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056.011328 Issued in IL

Practice address

1800 1St Capitol Dr
Saint Charles, MO 63301-1646

Phone

(636) 255-8094

NPI assigned

Nov 29, 2017

Last updated

Nov 29, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511913600000",
    "number": "1730693789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 E 3RD ST",
            "city": "AVISTON",
            "state": "IL",
            "postal_code": "622163473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 1ST CAPITOL DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633011646",
            "telephone_number": "636-255-8094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWDERN",
        "first_name": "KRISTEN",
        "middle_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-29",
        "last_updated": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.011328",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "200803561",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jocelyn Jeanne Bosch, OT
• Cynthia Lee Boschert, LPC
• Boulevard Dental Care L.L.C.
• Michael Bournstein, LPC
• Matthew Bowden, ATC
• Mary Beth Bowman, LCSW
• Natalie Grace Bowman
• Teresa M Bowman, IBCLC
• Brian A Boyd, MD
• Jeffery Jay Boyd, LMT

• Occupational Therapist in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2017; 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.