Derrick Bowling MD PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

DERRICK BOWLING MD PA

Practice address

3516 NE 12TH Ave
Oakland Park, FL 33334-4524

Phone

(954) 459-5487

NPI assigned

Mar 11, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Derrick Bowling, MD

Title

MD/Owner

Phone

(205) 388-8863

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583884800000",
    "number": "1770118655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 NE 22ND ST",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051115",
            "telephone_number": "205-388-8863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3516 NE 12TH AVE",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333344524",
            "telephone_number": "954-459-5487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERRICK BOWLING MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-11",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A",
        "authorized_official_last_name": "BOWLING",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "205-388-8863",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Determined Care

• Primary Care Clinic/Center in Oakland Park, FL
• Providers in Oakland Park, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.