NPIMap

Individual provider Active NPI

Derek Bowman

  • Family Nurse Practitioner
  • Washington, PA
National Provider Identifier
1942921663
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP025999 Issued in PA
Practice address
37 Highland Ave
Washington, PA 15301-4062
Phone
(724) 223-1067
NPI assigned
Sep 9, 2022
Sex
Male
Sole proprietor
Yes

Organizations & group practices 28

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.

View all 28

Hospital & facility affiliations 2

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

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centerville Clinics, Inc. 44 clinicians

Practice addresses (Care Compare)

37 Highland Ave
Washington, PA 15301-4062
Phone (724) 223-1067

Hospital & facility affiliations

  • Washington Hospital, the Hospital, Washington, PA, CCN 390042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20230105002507 PA Practitioner - Nurse Practitioner 6406226562 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP025999PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centerville Clinics, Inc. CurrentSince Dec 22, 2022 Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
Centerville Clinics, Inc CurrentSince Dec 22, 2022 Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
Centerville Clinics, Inc. Past Accepting new patients

Locations

1070 Old National Pike
Fredericktown, PA 15333

37 Highland Ave
Washington, PA 15301
Phone (724) 223-1067

Interoperability endpoints

  • Direct secure messaging: derek.bowman.1@33484.direct.athenahealth.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP025999 PA Primary

Addresses

NPPES NPI Registry

Primary practice location

37 Highland Ave
Washington, PA 15301-4062

Mailing address

1070 Old National Pike
Fredericktown, PA 15333-2114
Phone (724) 632-6801

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 9, 2022.

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1942921663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 OLD NATIONAL PIKE",
            "city": "FREDERICKTOWN",
            "state": "PA",
            "postal_code": "153332114",
            "telephone_number": "724-632-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 HIGHLAND AVE",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153014062",
            "telephone_number": "724-223-1067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "DEREK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-09",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP025999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, PA

Sources for this page

Verify at the official NPI Registry.