Kenny Lane Bowman, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

03047 Issued in KY

Practice address

2710 N Stemmons Fwy (Maxim Physician Resources)
Suite 100, North Tower
Dallas, TX 75207-2210

Phone

(888) 800-1853

Fax

(214) 741-0701

NPI assigned

Aug 5, 2007

Last updated

Jan 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbowma04@yourcarecommunity.org

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

• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382
  Medicare reassignment NPD
• Western Healthcare Services Kentucky LLC

  • Emergency Medicine Physician
  • Jackson, KY
  • NPI 1770243842
  Medicare reassignment NPD
• Kenny L Bowman DO PLLC

  • Family Medicine Physician
  • Springfield, KY
  • NPI 1932356656
  NPD (past) Authorized official
• Jackson Hospital Corporation

  dba Kentucky River ER, Anesth, Radiology

  • Emergency Medicine Physician
  • Jackson, KY
  • NPI 1679774996
  NPD (past)
• Jackson Physician Corp

  • General Practice Physician
  • Jackson, KY
  • NPI 1841234671
  NPD (past)
• Marshall Emergency Services Associates, PLLC

  • Emergency Medicine Physician
  • Lexington, KY
  • NPI 1891737185
  NPD (past)
• Southern Medical Partners, LLC

  • Emergency Medicine Physician
  • Hazard, KY
  • NPI 1538109962
  NPD (past)
• Springfield Medical Assoc PSC

  • Internal Medicine Physician
  • Springfield, KY
  • NPI 1386620102
  NPD (past)

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1740471960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 CEDAR HILLS DR",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415018700",
            "telephone_number": "606-432-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 N STEMMONS FWY (MAXIM PHYSICIAN RESOURCES)",
            "address_2": "SUITE 100, NORTH TOWER",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752072210",
            "telephone_number": "888-800-1853",
            "fax_number": "214-741-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "KENNY",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "03047",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "03047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100044960",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allissa Mary Bowman, PA-C
• Avery Elizabeth Bowman
• Charles Bradley Bowman, MD
• Chelsea Bowman
• Erin Marie Bowman, MD
• Mary Lou Bowman, PA-C
• Raeann Lanae Bowman, MD
• Robert Wayne Bowman Jr., MD
• Elena Bowne
• Jennifer Bernadette Bowring

• Family Medicine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.