Sandra W Bowker, PHD, ABPP

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

6301010557 Issued in MI

Practice address

5148 Lovers LN Ste 2
Portage, MI 49002-1572

Phone

(269) 343-3010

Fax

(269) 343-3017

NPI assigned

May 9, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sandra Bowker and Associates, PLCGroup PAC ID 4789737263, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Sandra Bowker and Associates, PLC

  • Clinical Neuropsychologist
  • Portage, MI
  • NPI 1609021369
  Medicare reassignment Care Compare group NPD
• Neuropsychology Associates PLC

  • Psychologist
  • Kalamazoo, MI
  • NPI 1447209051
  NPD (past)

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449360000000",
    "number": "1780633388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5148 LOVERS LN STE 2",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021572",
            "telephone_number": "269-343-3010",
            "fax_number": "269-343-3017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5148 LOVERS LN STE 2",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021572",
            "telephone_number": "269-343-3010",
            "fax_number": "269-343-3017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWKER",
        "first_name": "SANDRA",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PHD, ABPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2015-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301010557",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301010557",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0C96409",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "6130541",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Borgess Medical Center
• Borgess Medical Center
• Lex Wayne Botkin
• Emily S Boulter, OTRL
• Rhiannon Bower, LLMSW
• Steven Jay Bowman, D.M.D., M.S.D.
• Amy Lynn Boyce, AU.D.
• Brooke Osborne Boyd, PA-C
• Lyndsey Boyd
• Mathew James Boyle

• Clinical Neuropsychologist in Portage, MI
• Providers in Portage, MI by specialty
• Clinical Neuropsychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.