Active NPI
Jeremy S Bowen, P.A.
- Physician Assistant
- Highland, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 12860 Troxler Ave
Highland, IL 62249-2898 - Phone
- (618) 651-2810
- Fax
- (618) 651-0077
- NPI assigned
- Aug 31, 2006
- Last updated
- Dec 18, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NU | Primary |
Addresses
Primary practice location
12860 Troxler Ave
Highland, IL 62249-2898
Mailing address
12860 Troxler Ave
Highland, IL 62249-2898
Phone (618) 651-2810
Other practice location 1
8 Cusumano Professional Plaza Dr
Mount Vernon, IL 62864-6736
Phone (618) 244-4800
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00365761 | Other | IL | RR MEDICARE NUMBER |
| P019009721 | Other | NY | BLUE CHOICE |
| PA0495 | Other | NY | PREFERRED CARE |
| 207988 | Other | IL | MEDICARE GROUP NUMBER |
| CK7203 | Other | IL | RR GROUP NUMBER |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jbowen74572@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other | |
| Direct Messaging Address | jbowen338356@ewd.direct.hshs.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Josephs Hospital of the Hospital Sisters of the Third Order of St F
Practice addresses (Care Compare)
12860 Troxler Ave
Highland, IL 62249-2806
Phone (618) 651-2810
12866 Troxler Ave
Highland, IL 62249-2806
Phone (618) 651-2600
1512 N Green Mount Rd
Ofallon, IL 62269-1953
Phone (618) 624-5510
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HSHS Prairie, Inc | Current | Accepting new patients | |
| SJL Health Systems Inc | Current | Accepting new patients | |
| St. Mary's Hospital, Centralia, Illinois | Current | Accepting new patients | |
| St. Mary's Hospital, Centralia, Illinois | Current | Accepting new patients | |
| HSHS Medical Group Inc | Past | Accepting new patients |
Locations
400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221
432 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5200
7420 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-3155
1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889
12860 Troxler Ave
Highland, IL 62249
Phone (618) 235-3687
8 Cusumano Professional Plaza Dr
Mount Vernon, IL 62864
Phone (618) 242-7819
1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100
Interoperability endpoints
- jbowen74572@direct-ehr-ssmhc.com
Organizations & group practices 9
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.
-
- Multi-Specialty Clinic/Center
- Springfield, IL
- NPI 1962644807
-
- Obstetrics & Gynecology Physician
- Mount Vernon, IL
- NPI 1033440722
-
dba SSM Health Medical Group
- Internal Medicine Physician
- Mount Vernon, IL
- NPI 1831101807
-
dba SSM Health St. Mary's Hospital - Centralia
- Emergency Medicine Physician
- Centralia, IL
- NPI 1770687196
-
dba HSHS Medical Group Family Medicine - Dieterich
- Rural Health Clinic/Center
- Dieterich, IL
- NPI 1033841192
-
dba Prairie Rose Health Care Center
- Skilled Nursing Facility
- Pana, IL
- NPI 1215037353
-
dba SSM Health St. Mary's Hospital - Centralia
- Anesthesiology Physician
- Centralia, IL
- NPI 1477097871
-
dba SSM Health St. Mary's Hospital - Centralia
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Centralia, IL
- NPI 1710105192
-
- Rural Health Clinic/Center
- Rushville, IL
- NPI 1487719480
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba HSHS Home Care Illinois
- Home Health Agency
- Effingham, IL
- NPI 1891758678
-
dba HSHS St. Elizabeth's Hospital
- General Acute Care Hospital
- O'Fallon, IL
- NPI 1629057302
-
dba Clinton County Rural Health
- Rural Health Clinic/Center
- Breese, IL
- NPI 1013002658
Hospital
-
dba St. Joseph's Hospital
- General Acute Care Hospital
- Breese, IL
- NPI 1457319154
-
dba HSHS St. Joseph's Hospital -Highland
- Critical Access Hospital
- Highland, IL
- NPI 1447352323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702857600000",
"number": "1972615920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12860 TROXLER AVE",
"city": "HIGHLAND",
"state": "IL",
"postal_code": "622492898",
"telephone_number": "618-651-2810",
"fax_number": "618-651-0077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12860 TROXLER AVE",
"city": "HIGHLAND",
"state": "IL",
"postal_code": "622492898",
"telephone_number": "618-651-2810",
"fax_number": "618-651-0077"
}
],
"practiceLocations": [
{
"address_1": "8 Cusumano Professional Plaza Dr",
"address_purpose": "LOCATION",
"city": "Mount Vernon",
"state": "IL",
"postal_code": "628646736",
"country_code": "US",
"telephone_number": "618-244-4800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOWEN",
"first_name": "JEREMY",
"middle_name": "S",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2023-12-18",
"certification_date": "2023-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE NUMBER",
"identifier": "P00365761",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE",
"identifier": "P019009721",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE",
"identifier": "PA0495",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP NUMBER",
"identifier": "207988",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR GROUP NUMBER",
"identifier": "CK7203",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jbowen74572@direct-ehr-ssmhc.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "jbowen74572@direct-ehr-ssmhc.com",
"address_1": "432 N Pleasant Ave",
"city": "Centralia",
"state": "IL",
"country_code": "US",
"postal_code": "628013006",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "432 N Pleasant Ave",
"city": "Centralia",
"state": "IL",
"country_code": "US",
"postal_code": "628013006",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jbowen338356@ewd.direct.hshs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "12860 Troxler Ave",
"city": "Highland",
"state": "IL",
"country_code": "US",
"postal_code": "622492898",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Highland, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.