Individual provider Active NPI

Jacquelyn Marie Bowers, M.D.

  • Emergency Medicine Physician
  • Dallas, TX
National Provider Identifier
1891906327
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD.201347 Issued in LA
Practice address
3500 Gaston Ave
Dallas, TX 75246-2017
Phone
(800) 422-9567
NPI assigned
May 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD.201347 LA Primary

Addresses

Primary practice location

3500 Gaston Ave
Dallas, TX 75246-2017

Mailing address

3500 Gaston Avenue
Baylor University Medical Center
Dallas, TX 75246
Phone (800) 422-9567

Other identifiers 1

IdentifierTypeStateIssuer
21487MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091020000404 LA Practitioner - Emergency Medicine 7810034188 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.201347LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cross Lake Emergency Group, LLC Emergency Medicine CurrentSince Oct 1, 2018 Accepting new patients
Lasalle Parish Hospital Service District #1 CurrentSince Jun 17, 2019 Accepting new patients
Lasalle Parish Hospital Service District #1 CurrentSince Jun 17, 2019 Accepting new patients
Concord North Texas, PLLC Emergency Medicine CurrentSince Jul 12, 2019 Accepting new patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Jun 1, 2019 Accepting new patients
Sound Physicians Emergency Medicine of Louisiana Inc Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Emergency Medicine CurrentSince Oct 1, 2019 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Jun 1, 2019 Accepting new patients
Ellis Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Dallas Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Brfhh Shreveport LLC Past Accepting new patients
Hebron Emergency Physicians PLLC Emergency Medicine Past Accepting new patients

Locations

323 W Walnut Ave
Bastrop, LA 71220
Phone (318) 283-3600

2351 Viking Dr
Bossier City, LA 71111
Phone (318) 681-4500

600 S Pine St
Deridder, LA 70634
Phone (337) 462-7100

165 Beech Springs Rd
Jonesboro, LA 71251
Phone (318) 259-4435

524 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 430-4455

4864 Jackson St
Monroe, LA 71202
Phone (318) 330-7000

1102 N Pine Rd
Olla, LA 71465
Phone (318) 495-5302

8001 Youree Dr
Shreveport, LA 71115
Phone (318) 212-3000

1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177

2600 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-4600

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

Organizations & group practices 12

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1891906327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 GASTON AVENUE",
            "address_2": "BAYLOR UNIVERSITY MEDICAL CENTER",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75246",
            "telephone_number": "800-422-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462017",
            "telephone_number": "800-422-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWERS",
        "first_name": "JACQUELYN",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "MD.201347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21487",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.