Individual provider Active NPI

Derek Shea Bowers, LCSW

  • Clinical Social Worker
  • Johnson City, TN
National Provider Identifier
1760833164
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7119 Issued in TN
Practice address
207 N Boone St Ste 13
Johnson City, TN 37604-5659
Phone
(423) 218-2217
Fax
(865) 338-5383
NPI assigned
Jun 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7119 TN Primary

Addresses

Primary practice location

207 N Boone St Ste 13
Johnson City, TN 37604-5659

Mailing address

207 N Boone St Ste 13
Johnson City, TN 37604-5659
Phone (865) 338-5384

Other identifiers 1

IdentifierTypeStateIssuer
Q053172MedicaidTN

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200723003217 TN Practitioner - Clinical Social Worker 0749604676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Next Step Behavioral Health LLCGroup PAC ID 3375873698, 14 clinicians

Practice addresses (Care Compare)

207 N Boone St
Suite 13
Johnson City, TN 37604-5659
Phone (865) 338-5384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7119TNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Next Step Behavioral Health LLC CurrentSince May 4, 2020 Accepting new patients
Omni Community Health, Inc. Clinical Past Accepting new patients

Locations

207 N Boone St
Ste 13
Johnson City, TN 37604
Phone (865) 219-3937

Organizations & group practices 2

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": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1760833164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N BOONE ST STE 13",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376045659",
            "telephone_number": "865-338-5384",
            "fax_number": "865-338-5383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 N BOONE ST STE 13",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376045659",
            "telephone_number": "423-218-2217",
            "fax_number": "865-338-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWERS",
        "first_name": "DEREK",
        "middle_name": "SHEA",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-27",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "7119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q053172",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.