Individual provider Active NPI

Mary Ann Bowlin, PA-C

  • Physician Assistant
  • Florence, KY
National Provider Identifier
1790711638
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA970 Issued in KY
Practice address
8726 US Highway 42
Florence, KY 41042
Phone
(859) 384-2660
Fax
(859) 384-5248
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA970 KY Primary

Addresses

Primary practice location

8726 US Highway 42
Florence, KY 41042

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 384-2660

Other identifiers 1

IdentifierTypeStateIssuer
7100141030MedicaidKY

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070109000090 KY Practitioner - Physician Assistant 7911900717 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Jul 1, 2010 Accepting new patients
Summit Medical Group, Inc Physician Assistant CurrentSince Jul 1, 2010 Accepting new patients
Comprehensive Cardiology Cons Inc Past Accepting new patients

Locations

350 Thomas More Pkwy
Ste 280
Crestview Hills, KY 41017
Phone (606) 426-0800

7370 Turfway Rd
Ste 109
Florence, KY 41042
Phone (513) 872-5700

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

8251 Pine Rd
Ste 220
Cincinnati, OH 45236
Phone (513) 246-4550

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.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1790711638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-384-2660",
            "fax_number": "859-384-5248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8726 US HIGHWAY 42",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "41042",
            "telephone_number": "859-384-2660",
            "fax_number": "859-384-5248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWLIN",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100141030",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, KY

Sources for this page

Verify at the official NPI Registry.