JEREMY S BOWEN (NPI# 1972615920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972615920 |
| Entity Type | Individual |
| Full Name | JEREMY S BOWEN |
| Credential | P.A. |
| Practice Address |
432 N Pleasant Ave Centralia IL 62801-3006 |
| Practice Telephone | 6184365200 |
| Practice Fax Number | 6184368066 |
| Mailing Telephone | 6184365200 |
| Mailing Fax Number | 6184368066 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-11-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
009721 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE GROUP NUMBER | 207988 | 01 |
| NY | BLUE CHOICE | P019009721 | 01 |
| IL | RR GROUP NUMBER | CK7203 | 01 |
| IL | RR MEDICARE NUMBER | P00365761 | 01 |
| NY | PREFERRED CARE | PA0495 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215409966 | Jeremy Bowen | Pharmacist | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2018-12-19 |
| 1942770128 | Jeremy Bradley Bowen | Physical Therapy Assistant | 1045 Broadway Park Ste 107, Homewood, AL 35209-6256 | 2018-11-29 |
| 1457889669 | Jeremy Bowen | Specialist/Technologist | 5200 N Lake Rd, Merced, CA 95343-5001 | 2017-06-01 |
| 1558619387 | Jeremy Adam Bowen | Social Worker | 1101 Veterans Dr, Lexington, KY 40502-2235 | 2012-08-28 |
| 1386845188 | Jeremy Lee Bowen | Dentist | 19201 E Valley View Pkwy, Suite A, Independence, MO 64055-6910 | 2007-05-30 |
| Street Address |
432 N PLEASANT AVE |
| City | CENTRALIA |
| State | IL |
| Zip Code | 62801-3006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326685983 | Chelsea M Price | Dietitian, Registered | 432 N Pleasant Ave, Centralia, IL 62801-3006 | 2019-12-03 |
| 1235776816 | Jaci Elizabeth Lake | Dietitian, Registered | 432 N Pleasant Ave, Centralia, IL 62801-3006 | 2019-12-03 |
| 1396288106 | Physician Services and Consulting, LLC | Surgery | 432 N Pleasant Ave, Centralia, IL 62801-3006 | 2016-11-28 |
| 1386815959 | Stacy D Menees | Nurse Practitioner | 432 N Pleasant Ave, Centralia, IL 62801-3006 | 2008-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996151 | Matthew Crawford | Counselor | 904 E Martin Luther King Dr, Centralia, IL 62801 | 2019-08-08 |
| 1588130314 | Kennah White | Counselor | 904 E. Mlk Drive, Centralia, IL 62801 | 2018-10-19 |
| 1245721588 | Lindsey Nicole Fogliasso | Counselor | 904 East Mlk Dr., Centralia, IL 62801 | 2018-05-22 |
| 1629573365 | Prabhat Shrestha | Student in an Organized Health Care Education/Training Program | 605 Sable Drive, Centralia, IL 62801 | 2018-03-26 |
| 1619496098 | Whitney Rathmann | Speech-Language Pathologist | 224 South Locust, Centralia, IL 62801 | 2017-09-17 |
| 1376082685 | Athena A Smith | Counselor | 904 E. Martin Luther King Dr, Centralia, IL 62801 | 2017-02-20 |
| 1447704069 | Meghan Branch | Counselor | 904 Martin Luther King Dr, Centralia, IL 62801 | 2016-08-11 |
| 1568820637 | Midland Area Agency On Aging | Case Management | 434 S Poplar Street, Centralia, IL 62801 | 2016-02-04 |
| 1104201714 | Keri Douglas | Nurse Practitioner | 1054 M. L. King Drive #125, Centrailia, IL 62801 | 2015-07-24 |
| 1215331509 | Melissa Dane | Counselor | 904 E Martin Luther King Dr., Centralia, IL 62801 | 2014-10-15 |
| Find all providers in zip 62801 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477169522 | Priority Assist Pllc | Physician Assistant | 48 Glenda Ln, Plano, IL 60545-9652 | 2020-09-23 |
| 1154944478 | Diana Goldak | Physician Assistant | 3855 N Parkway Dr Apt 3a, Northbrook, IL 60062-7218 | 2020-05-20 |
| 1033742580 | Colleen Courtney | Physician Assistant | 218 S Driftwood Trl, Mchenry, IL 60050-5454 | 2020-02-12 |
| 1326678962 | Nina Kodros | Physician Assistant | 301 Madison St Ste 280, Joliet, IL 60435-6672 | 2020-01-23 |
| 1689218190 | Jennifer Richman | Physician Assistant | 1890 Silver Cross Blvd Ste 410, New Lenox, IL 60451-9547 | 2019-10-29 |
| 1710547625 | Nadia Khan | Physician Assistant | 4543 N Malden St Apt 1s, Chicago, IL 60640-5687 | 2019-06-13 |
| 1962065516 | Jorge Mantilla | Physician Assistant | 5540 N Kimball Ave Apt 3e, Chicago, IL 60625-4674 | 2019-04-18 |
| 1013479955 | Leah Rae Prager | Physician Assistant | 4400 W. 95th St., Attn: Pediatric General Surgery, Oak Lawn, IL 60453 | 2019-04-01 |
| 1770041949 | Laura Ann Ryan | Physician Assistant | 840 S Wood St Ste 417, Chicago, IL 60612-4325 | 2019-03-06 |
| 1548739782 | Helen Finke | Physician Assistant | 880 W Central Rd Ste 3300, Arlington Heights, IL 60005-2366 | 2018-11-16 |
| Find all providers with the same taxonomy | ||||
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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.