Emily Virginia Bowling, M.S. R.D.
Individual provider Active NPI Registered Dietitian · Crestview, FL
NPI 1821353046 · NPPES record last updated Jun 12, 2024
Key facts
- NPI
- 1821353046
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- Practice address
- 1078 S Ferdon Blvd
Crestview, FL 32536-4502 - Phone
- (850) 682-0381
- NPI assigned
- Jul 13, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240715002449 | VA | Practitioner - Registered Dietitian Or Nutrition Professional | 1658816665 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND6317 | FL | MD | Registered Dietitian |
| DT81061 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lwell LLC | Dietitian, Registered | Current |
Accepting new patients |
Locations
1309 Jamestown Rd
Ste 102
Williamsburg, VA 23185
Phone (757) 220-4917
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | ND6317 | FL | |
| Registered Dietitian | 133V00000X | DT81061 | TX | |
| Registered Dietitian | 133V00000X | Yes |
Addresses
Primary practice location
1078 S Ferdon Blvd
Crestview, FL 32536-4502
Mailing address
4686 Hickory Signpost Rd
Williamsburg, VA 23185-2462
Phone (210) 464-0313
Other providers in Crestview, FL
- Alisia Michelle Bolin
- Emma Bombriant
- Amy Bondurant
- Robert Alan Bortz
- Marcello A Borzatta
- Brandi Suzanne Boyette
- Melissa Leigh Bracewell
- Chelsie C Braden
- Haleigh Bradley
- Mary Catherine Brant
All providers in Crestview, FL · Registered Dietitian in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.