Individual provider Active NPI

Roberta M Bowen, NNP

  • Critical Care Neonatal Nurse Practitioner
  • Providence, RI
National Provider Identifier
1841409976
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
APRN01208 Issued in RI
Practice address
101 Dudley Street
Providence, RI 02905-2401
Phone
(401) 274-1122
Fax
(401) 453-7571
NPI assigned
May 22, 2007
Last updated
Aug 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X APRN01208 RI Primary

Addresses

Primary practice location

101 Dudley Street
Providence, RI 02905-2401

Mailing address

455 Toll Gate Road
PRC and Credentialing
Warwick, RI 02886-2759
Phone (401) 273-0641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20140418000748 RI Practitioner - Nurse Practitioner 0941369771 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Oct 1, 2016 Accepting new patients
Affinity Physicians LLC. CurrentSince Oct 1, 2016 Accepting new patients
Silver Spring Health Care Management, Inc. CurrentSince Jan 1, 2014 Accepting new patients
Silver Spring Health Care Management, Inc. CurrentSince Jan 1, 2014 Accepting new patients
Silver Spring Health Care Management, Inc Past Accepting new patients

Locations

101 Dudley St
Providence, RI 02905
Phone (401) 453-7950

100 Kenyon Ave
Wakefield, RI 02879
Phone (401) 782-8000

70 Kenyon Ave
Unit 211
Wakefield, RI 02879
Phone (401) 789-8543

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1841409976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE ROAD",
            "address_2": "PRC AND CREDENTIALING",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-273-0641",
            "fax_number": "401-273-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DUDLEY STREET",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052401",
            "telephone_number": "401-274-1122",
            "fax_number": "401-453-7571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "ROBERTA",
        "middle_name": "M",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "RI",
            "license": "APRN01208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.