Individual provider Active NPI

Dantae Bowie, D.O.

  • Urology Physician
  • Fort Moore, GA
National Provider Identifier
1780840728
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
86459 Issued in GA
Practice address
6600 Van Aalst Blvd
Fort Moore, GA 31905-2102
Phone
(762) 408-3566
Fax
(762) 408-8119
NPI assigned
Jul 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 86459 GA Primary

Addresses

Primary practice location

6600 Van Aalst Blvd
Fort Moore, GA 31905-2102

Mailing address

2300 Manchester Expy Ste 2001a
Columbus, GA 31904-6802
Phone (706) 320-3126

Other practice location 1

2300 Manchester Expy Ste A002
Columbus, GA 31904-6805
Phone (706) 320-3203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20201109003204 GA Practitioner - Urology 3577973296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Oklahoma State University College of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Francis Physician Practices LLCGroup PAC ID 8729381033, 217 clinicians

Practice addresses (Care Compare)

2300 Manchester Expy
Suite A002
Columbus, GA 31904-6805
Phone (706) 576-4648

Hospital & facility affiliations

  • St Francis Hospital- Emory Healthcare Hospital, Columbus, GA, CCN 110129
  • Piedmont Columbus Regional Midtown Hospital, Columbus, GA, CCN 110064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
86459GAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Physician Practices LLC Urology CurrentSince Jan 1, 2021 Accepting new patients
St. Francis Physician Practices LLC CurrentSince Jan 1, 2021 Accepting new patients
St. Francis Physician Practices LLC Current Accepting new patients
St. Francis Center for Surgical Care, LLC Past Accepting new patients

Locations

2548 Weems Rd
Columbus, GA 31909
Phone (404) 265-4000

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

2300 Manchester Expy
Ste A002
Columbus, GA 31904
Phone (706) 320-3203

2300 Manchester Expy
Ste 2001A
Columbus, GA 31904
Phone (706) 320-3126

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1780840728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 MANCHESTER EXPY STE 2001A",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046802",
            "telephone_number": "706-320-3126",
            "fax_number": "706-320-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD",
            "city": "FORT MOORE",
            "state": "GA",
            "postal_code": "319052102",
            "telephone_number": "762-408-3566",
            "fax_number": "762-408-8119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Manchester Expy Ste A002",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319046805",
            "country_code": "US",
            "telephone_number": "706-320-3203",
            "fax_number": "706-243-6581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWIE",
        "first_name": "DANTAE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-30",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "86459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Moore, GA

Sources for this page

Verify at the official NPI Registry.