Samuel Todd Bowman, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2264 Issued in FL

Practice address

120 A1A N Ste 101
Ponte Vedra Beach, FL 32082-6626

Phone

(904) 280-9000

Fax

(904) 280-4448

NPI assigned

Jun 6, 2006

Last updated

Mar 22, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• DRS. Wood, Lanier & Bowman, PA

  • Optometrist
  • Ponte Vedra Beach, FL
  • NPI 1437330461
  Authorized official Same address or phone
• Bowman Optometry, PA

  dba Smith Eye Associates

  • Optometrist
  • Ponte Vedra Beach, FL
  • NPI 1790921260
  NPD
• DRS. Wood Lanier and Bowman, PA

  • Optometrist
  • Jacksonville, FL
  • NPI 1437170388
  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1871532754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 A1A N STE 101",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320826626",
            "telephone_number": "904-280-9000",
            "fax_number": "904-280-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 A1A N STE 101",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320826626",
            "telephone_number": "904-280-9000",
            "fax_number": "904-280-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "SAMUEL",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "2264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "20126",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "20126A",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luke Maxwell Bote'
• Blake William Boudreaux, MD
• Clarence E Boudreaux, M.D.
• Molly Ann Bowie, B.S.
• Bowman Optometry, PA (Smith Eye Associates)
• Angela Chris Bradberry, M. ED
• Mitchell Brady, DO
• Branch Lane Psychotherapy
• Lisa Braren, AP
• Daniel Brisuda

• Optometrist in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.