Tara Bowman, RD
Individual provider Active NPI Registered Dietitian · Evergreen, AL
NPI 1992101331 · NPPES record last updated Sep 5, 2019
Key facts
- NPI
- 1992101331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- Practice address
- 344 Bruner Ave
Evergreen, AL 36401-3145 - Phone
- (602) 618-9883
- NPI assigned
- Nov 12, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Nourish, Inc.
Practice addresses (Care Compare)
3724 Jefferson St
Suite 104
Austin, TX 78731-6204
Phone (512) 693-7045
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240318002791 | TX | Practitioner - Registered Dietitian Or Nutrition Professional | 3274970934 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Yes |
Addresses
Primary practice location
344 Bruner Ave
Evergreen, AL 36401-3145
Mailing address
344 Bruner Ave
Evergreen, AL 36401-3145
Other names
- Tara McQueen
Other providers in Evergreen, AL
- Aubrey a. Odom, O.D. P.C.
- Barnes Family Medical Associates PC
- Stanley Barnes
- Bayside Orthopaedic & Rehabilitation Center, P.C.
- Rickey Allen Blackburn Jr.
- Sylvia Annette Brinson
- Willis Brown
- Latonya Burroughs
- City Drug Store, Inc.
- Conecuh County
All providers in Evergreen, AL · Registered Dietitian in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.