Individual provider Active NPI

Brendan Kelly Bowens, MD

  • Internal Medicine Physician
  • Bethesda, MD
National Provider Identifier
1851969034
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2022045945 Issued in MO
Practice address
3901 Rockville Pike
Bethesda, MD 20889-5650
Phone
(301) 295-4000
NPI assigned
Jun 15, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X
Internal Medicine Physician 207R00000X 2022045945 MO Primary

Addresses

Primary practice location

3901 Rockville Pike
Bethesda, MD 20889-5650

Mailing address

300 East Hospital Road
Fort Gordon, GA 30905-5650

Other practice location 1

300 East Hospital Road
Fort Gordon, GA 30905-5650
Phone (706) 787-5811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2022045945MOMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1851969034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 EAST HOSPITAL ROAD",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 ROCKVILLE PIKE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208895650",
            "telephone_number": "301-295-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 East Hospital Road",
            "address_purpose": "LOCATION",
            "city": "Fort Gordon",
            "state": "GA",
            "postal_code": "309055650",
            "country_code": "US",
            "telephone_number": "706-787-5811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWENS",
        "first_name": "BRENDAN",
        "middle_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-15",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2022045945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.