Individual provider Active NPI

Bradley John Bowles, M.D.

  • Vascular Surgery Physician
  • Provo, UT
National Provider Identifier
1922458892
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
13253486-1235 Issued in UT
Practice address
395 W Cougar Blvd Ste 503
Provo, UT 84604-3323
Phone
(801) 374-9100
Fax
(801) 374-9117
NPI assigned
Jun 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 2022046851 MO
Vascular Surgery Physician 2086S0129X 62608 AZ
Vascular Surgery Physician 2086S0129X 13253486-1235 UT Primary

Addresses

Primary practice location

395 W Cougar Blvd Ste 503
Provo, UT 84604-3323

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 374-9100

Other practice location 1

10012 Kennerly Rd Ste 305
Saint Louis, MO 63128-2197
Phone (314) 525-4325

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRReguest_Service Other Bluemark LLC / Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, MO, UT3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210719000747 AZ Practitioner - Vascular Surgery 4486941945 Reassigns benefits to 2 organizations
I20221214002860 MO Practitioner - Vascular Surgery 4486941945 Reassigns benefits to 4 organizations
I20230927002649 UT Practitioner - Vascular Surgery 4486941945 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Arizona College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

395 W Bulldog Blvd
Suite 503
Provo, UT 84604-3323
Phone (801) 374-9100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Coronary artery bypass graft (CABG)1-10
Varicose vein removal1-10
Leg revascularization (restoring blood flow)26
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62608AZMDVascular Surgery Physician
2022046851MOMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Joplin LLC Family Medicine CurrentSince Apr 1, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince Aug 25, 2024 Accepting new patients
Signify Health, LLC CurrentSince Apr 17, 2023 Accepting new patients
Vascular Heart & Lung Associates, PC Vascular Surgery CurrentSince Sep 1, 2021 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Mar 1, 2023 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Mar 1, 2023 Accepting new patients
Ihc Health Services Inc Family Medicine CurrentSince Aug 25, 2024 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Mar 1, 2023 Accepting new patients
Squaw Peak Anesthesia Inc PastSince Jul 20, 2021 Accepting new patients
Ihc Health Services Inc Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

2705 S Alma School Rd
Chandler, AZ 85286
Phone (480) 820-7246

10238 E Hampton Ave
Ste 205
Mesa, AZ 85209
Phone (480) 354-6463

3850 E Baseline Rd
Ste 103
Mesa, AZ 85206
Phone (480) 722-7589

448 State Highway 248
Ste 160
Branson, MO 65616
Phone (417) 213-4696

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

100 Mercy Way
Ste 310
Joplin, MO 64804

2300 Main St
Fl 9
Kansas City, MO 64108
Phone (800) 416-1767

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

2115 S Fremont Ave
Springfield, MO 65804
Phone (417) 820-3912

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

2115 S Fremont Ave
Ste 5000
Springfield, MO 65804
Phone (417) 820-3912

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

395 W Cougar Blvd
Ste 503
Provo, UT 84604
Phone (801) 357-4600

9980 S 300 W
Ste 200
Sandy, UT 84070
Phone (801) 285-7403

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1922458892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-374-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W COUGAR BLVD STE 503",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043323",
            "telephone_number": "801-374-9100",
            "fax_number": "801-374-9117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10012 Kennerly Rd Ste 305",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282197",
            "country_code": "US",
            "telephone_number": "314-525-4325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWLES",
        "first_name": "BRADLEY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-21",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MO",
            "license": "2022046851",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AZ",
            "license": "62608",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "UT",
            "license": "13253486-1235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRReguest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.