Bowman J Blake, APRN

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

10709846-4405 Issued in UT

Practice address

35 S 400 W
Orem, UT 84058-5324

Phone

(801) 800-2550

Fax

(801) 705-4040

NPI assigned

Sep 16, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1992427892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 S 400 W",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840585324",
            "telephone_number": "801-800-2550",
            "fax_number": "801-705-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 S 400 W",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840585324",
            "telephone_number": "801-800-2550",
            "fax_number": "801-705-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "BOWMAN",
        "middle_name": "J",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-16",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "10709846-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Blacker Blacker, PMHNP-C
• Makayla Ashley Blackford
• Hannah Calista Blackham
• Jon M. Blackham
• Morgan Blackhurst
• Stephanie Kuulei Blake, LCSW
• Hayley Blan
• Brianna Renee Blanchard
• Kortney Blatter
• Charity Celeste Blaylock

• Family Medicine Physician in Orem, UT
• Providers in Orem, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.