Melissa Nicole Bowen, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9106880 Issued in FL

Practice address

830 Executive LN Ste 140
Rockledge, FL 32955-3595

Phone

(321) 635-0202

NPI assigned

Aug 9, 2012

Last updated

Mar 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2025 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1871840850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5846 INDIGO CROSSING DR",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329556017",
            "telephone_number": "321-720-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 EXECUTIVE LN STE 140",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553595",
            "telephone_number": "321-635-0202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8043 Spyglass Hill Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329408563",
            "country_code": "US",
            "telephone_number": "321-755-6899",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1565 Sarno Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329355268",
            "country_code": "US",
            "telephone_number": "321-635-0202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "MELISSA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-09",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Bordac
• Amber Borns
• Timothy J Bortz, DC
• Matthew Norman Boucher, DC
• Shondell M Bouie, MD
• Lucille Pearl Bowles
• Ann R Bowley, PSYS
• Gerald Bowman, PTA, DC
• Jennifer Lynn Bowman, M.S. CCC-SLP
• Ryan A. Boyer, ATC

• Physician Assistant in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.