1073587051 NPI number — PATTI JO BOWMAN PA-C

Table of content: PATTI JO BOWMAN PA-C (NPI 1073587051)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073587051 NPI number — PATTI JO BOWMAN PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOWMAN
Provider First Name:
PATTI
Provider Middle Name:
JO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073587051
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/17/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DEPT OF EMERGENCY MEDICINE UK HEALTHCARE
Provider Second Line Business Mailing Address:
800 ROSE STREET M50
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40536-0298
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-323-5908
Provider Business Mailing Address Fax Number:
859-323-8056

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 S LIMESTONE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40536-1793
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-323-5908
Provider Business Practice Location Address Fax Number:
859-323-8056
Provider Enumeration Date:
02/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AM0700X , with the licence number:  PA255 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AS0400X , with the licence number: PA255 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: PA-255 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000377997 . This is a "ANTHEM PROVIDER #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 61-1427889 . This is a "CHA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 61-1427889 . This is a "TRICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: C60875 . This is a "CUMBERLAND HEALTHCARE INC" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 61-1427889 . This is a "UHC" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 95003034 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 030670000 . This is a "BLACK LUNG" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 61-1427889 . This is a "BLUEGRASS FAMILY HEALTH" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50005618 . This is a "PASSPORT HEALTH PLAN" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 61-1427889 . This is a "HUMANA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com