Lauren Deann Bouwman, PT, CLT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05010491A Issued in IN

Practice address

16000 W 101St Ave
Dyer, IN 46311-3065

Phone

(219) 365-6333

Fax

(219) 365-8291

NPI assigned

Dec 3, 2012

Last updated

Apr 9, 2021By 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 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lauren.bouwman@mmgsc.eclinicaldirect.com

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.

• Independence Physical Therapy, PC

  • Physical Therapist
  • Crete, IL
  • NPI 1134456007
  NPD

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1932444908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15900 W 101ST AVE",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463113065",
            "telephone_number": "219-365-6333",
            "fax_number": "219-365-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 W 101ST AVE",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463113065",
            "telephone_number": "219-365-6333",
            "fax_number": "219-365-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUWMAN",
        "first_name": "LAUREN",
        "middle_name": "DEANN",
        "credential": "PT, CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-03",
        "last_updated": "2021-04-09",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05010491A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "05010491A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lauren.bouwman@mmgsc.eclinicaldirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "16000 W 101st Ave",
            "city": "Dyer",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463113065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alyssa Marie Borkowski
• Valerie Boromisa, LCSW
• Jessica Bosques, LCPC
• Melissa Dawn Bourland, OD
• Seth Bouwer
• Virginia E Bratcher, MS ED
• David Bruce Braunstein, D.O.
• Elizabet Braviere
• Briggs Ophthalmology & Associates, S.C.
• Karen Sue Briggs, D.O.

• Physical Therapist in Dyer, IN
• Providers in Dyer, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.