Active NPI
Charles Ray Bowman III, AIDE
- Licensed Practical Nurse
- Middletown, OH
National Provider Identifier
1841346178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN128898IV
- Practice address
- 4301 Lisa LN
Middletown, OH 45042-2838 - Phone
- (513) 594-7940
- NPI assigned
- Jan 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | |||
| Licensed Practical Nurse | 164W00000X | PN128898IV | OH | Primary |
Addresses
Primary practice location
4301 Lisa LN
Middletown, OH 45042-2838
Mailing address
4301 Lisa LN
Middletown, OH 45042-2838
Phone (513) 594-7940
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2583422 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN128898IV | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200182400000",
"number": "1841346178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 LISA LN",
"city": "MIDDLETOWN",
"state": "OH",
"postal_code": "450422838",
"telephone_number": "513-594-7940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4301 LISA LN",
"city": "MIDDLETOWN",
"state": "OH",
"postal_code": "450422838",
"telephone_number": "513-594-7940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWMAN",
"first_name": "CHARLES",
"middle_name": "RAY",
"name_suffix": "III",
"credential": "AIDE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-27",
"last_updated": "2008-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "PN128898IV",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2583422",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Middletown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.