DR. DIANE GWYN BOWEN (NPI# 1215950431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215950431 |
| Entity Type | Individual |
| Full Name | DR. DIANE GWYN BOWEN |
| Credential | M.D. |
| Practice Address |
1015 Arthur J Moore Dr Saint Simons Island GA 31522-2206 |
| Practice Telephone | 9126341993 |
| Practice Fax Number | 9126341166 |
| Mailing Telephone | 9126341993 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
31386 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | CAQH NUMBER | 11340888 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578800488 | Diane Irene Bowen | Occupational Therapy Assistant | 81 Chatham St, Worcester, MA 01609-2027 | 2013-01-11 |
| Street Address |
1015 ARTHUR J MOORE DR |
| City | SAINT SIMONS ISLAND |
| State | GA |
| Zip Code | 31522-2206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922387349 | Laura Hepner | Massage Therapist | 1015 Arthur J Moore Dr, Saint Simons Island, GA 31522-2206 | 2011-08-16 |
| 1215254065 | Golden Isles Medical LLC | Specialist | 1015 Arthur J Moore Dr, Saint Simons Island, GA 31522-2206 | 2010-05-03 |
| 1386736064 | Robert W Bowen | Obstetrics & Gynecology | 1015 Arthur J Moore Dr, Saint Simons Island, GA 31522-2206 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982186342 | Matthew Mackinnon Gibbs | Specialist/Technologist | 211 Village Dr, St Simons Is, GA 31522 | 2018-09-02 |
| 1770957433 | Jennifer Herrin, Lpc | Community/Behavioral Health | 400 Main Street, Cottage 1, Saint Simons Island, GA 31522 | 2015-11-18 |
| 1508113002 | Ashley Neal Callicutt | Counselor | 301 Sea Island Road, Suite G, St. Simons Island, GA 31522 | 2012-08-14 |
| 1235414103 | Dana D'andrea Duggan | Psychologist | 283 Redfern Village, St. Simons Island, GA 31522 | 2011-10-11 |
| 1528394848 | Nancy Hodges Bowen | Nurse Practitioner | 7000 Wellness Way, Suite 130, St. Simons Island, GA 31522 | 2009-10-21 |
| 1073763215 | John Arthur Hendry | Dentist | 511 Mallery Street, St. Simons Island, GA 31522 | 2008-09-24 |
| 1770775116 | Randolph M. Stevens | Dentist | Coastal Endodontic Associates, 1804 Frederica Rd., Ste B, St. Simons Island, GA 31522 | 2007-08-09 |
| 1689797383 | Angela C Barnard | Nurse Practitioner | 798 Mallery St Apt 2, Saint Simons Island, GA 31522 | 2007-04-09 |
| 1053493486 | Larry D. Daugherty | Dentist | 124 Island Professional Park, St Simons Island, GA 31522 | 2006-10-19 |
| 1134239460 | Joe Neil Garner | Dentist | 288 Redfern Village, St Simons Island, GA 31522 | 2006-08-30 |
| Find all providers in zip 31522 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427668342 | Spa Medical LLC | Surgery | 455 Plum St, Macon, GA 31201-3368 | 2020-08-05 |
| 1356972848 | North Atlanta Plastic Surgery Group LLC | Surgery | 11877 Douglas Rd Ste 102-367, Johns Creek, GA 30005-4325 | 2020-02-03 |
| 1881100337 | Rpc Employee Services, LLC | Surgery | 975 Johnson Ferry Rd Ste 100, Atlanta, GA 30342-1618 | 2017-12-20 |
| 1093255044 | Southeastern Aesthetic and Reconstructive Surgery | Surgery | 155 Greenville St, Newnan, GA 30263-2630 | 2017-02-24 |
| 1700249042 | Justin Kyle Williams | Surgery | 3200 Downwood Cir Nw Ste 640-4, Atlanta, GA 30327-1610 | 2016-04-04 |
| 1871901009 | Southeastern Reconstructive Services LLC | Surgery | 5205 Frederick St Ste B, Savannah, GA 31405-4520 | 2014-07-31 |
| 1730479452 | Olumayowa Pitan Abiodun | Surgery | 2709 Meredyth Dr Ste 340, Albany, GA 31707 | 2011-04-14 |
| 1609175421 | Randal H. Rudderman Md Inc | Surgery | 3400-c Old Milton Pkwy, Ste 450, Alpharetta, GA 30005-3707 | 2011-03-18 |
| 1033374392 | James Bradford Depew | Surgery | 120 Vann St Ne Ste 150, Marietta, GA 30060 | 2008-07-25 |
| 1255591814 | Corey Patrick Harkins | Surgery | 120 Vann Street, Suite 150, Marietta, GA 30060 | 2008-06-16 |
| Find all providers with the same taxonomy | ||||
| City | SAINT SIMONS ISLAND |
| Zip Code | 31522 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.