Active NPI
Kendra G Bowman, MD, PHD
- Surgery Physician
- Boise, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 62401-20
- Practice address
- 100 E Idaho St
Ste. 300
Boise, ID 83712-6267 - Phone
- (208) 381-7370
- NPI assigned
- Mar 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 245014 | MA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 4301087754 | MI | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 245014 | MA | |
| Surgery Physician | 208600000X | 62401-20 | WI | Primary |
Addresses
Primary practice location
100 E Idaho St
Ste. 300
Boise, ID 83712-6267
Mailing address
100 E Idaho St
Ste. 300
Boise, ID 83712-6267
Phone (208) 381-7370
Other practice location 1
1000 N Oak Avenue
Marshfield, WI 54449
Phone (715) 387-5511
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | him@marshfieldclinichealthsystem.cernerdirect.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 245014 | MA | MD | Student in an Organized Health Care Education/Training Program |
| 4301087754 | MI | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCHS Hospitals Inc | Current | Accepting new patients | |
| MCHS Hospitals Inc | Current | Accepting new patients | |
| Marshfield Clinic Inc | Surgery | Current | Accepting new patients |
Locations
3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200
1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111
Interoperability endpoints
- kendra.bowman@marshfieldclinichealthsystem.cernerdirect.com
- him@marshfieldclinichealthsystem.cernerdirect.com
Organizations & group practices 3
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.
-
dba Marshfield Clinic Florida Teleradiology/Telehealth
- Clinic/Center
- Marshfield, WI
- NPI 1952347981
Surgery
-
dba Marshfield Medical Center - Eau Claire Cancer Center
- Durable Medical Equipment & Medical Supplies
- Eau Claire, WI
- NPI 1558230847
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714348800000",
"number": "1811029507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 E IDAHO ST",
"address_2": "STE. 300",
"city": "BOISE",
"state": "ID",
"postal_code": "837126267",
"telephone_number": "208-381-7370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E IDAHO ST",
"address_2": "STE. 300",
"city": "BOISE",
"state": "ID",
"postal_code": "837126267",
"telephone_number": "208-381-7370"
}
],
"practiceLocations": [
{
"address_1": "1000 N Oak Avenue",
"address_purpose": "LOCATION",
"city": "Marshfield",
"state": "WI",
"postal_code": "54449",
"country_code": "US",
"telephone_number": "715-387-5511",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOWMAN",
"first_name": "KENDRA",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "MD, PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-09",
"last_updated": "2024-04-29",
"certification_date": "2024-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MA",
"license": "245014",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "4301087754",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MA",
"license": "245014",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "62401-20",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
"affiliation": "N",
"address_1": "1000 N Oak Avenue",
"city": "Marshfield",
"state": "WI",
"country_code": "US",
"postal_code": "54449",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.