Shasta Nicole Bowens (NPI# 1013443191, PAC ID# 7810253705) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1013443191 |
| PAC ID by PECOS | 7810253705 |
| Professional Enrollment ID | I20190530002257 |
| Full Name | Shasta Nicole Bowens |
| Organization Legal Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Address |
2000 Brookside Dr Suite 3 Kingsport TN 37660-4627 |
| Phone Number | 4238575905 |
| Gender | F |
| Graduation Year | 2016 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 9739099441 |
| Number of Group Practice Members | 316 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440063 | JOHNSON CITY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2000 Brookside Dr, Suite 3, Kingsport, TN 37660-4627 | 4238575905 | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Organization Legal Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Physicians | 289 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Deneene R Booth | Anesthesiology | Blue Ridge Medical Management Corporation | 601 Campus Dr, Abingdon, VA 24210-9700 |
| Luc Jasmin | Neurosurgery | Blue Ridge Medical Management Corporation | 701 Med Tech Pkwy, Suite 300, Johnson City, TN 37604-2365 |
| Sandra Michelle Sparks | Nurse Practitioner | Blue Ridge Medical Management Corporation | 310 N State of Franklin Rd, Suite 400, Johnson City, TN 37604-6529 |
| Rebecca Sacora | Family Medicine | Blue Ridge Medical Management Corporation | 2030 Temple Hill Rd, Suite B, Erwin, TN 37650-8721 |
| Leslie Renee Barlow | Nurse Practitioner | Blue Ridge Medical Management Corporation | 1201 Snider St, Marion, VA 24354-4221 |
| Sheila Ann Matherly | Nurse Practitioner | Blue Ridge Medical Management Corporation | 404 Bemberg Rd, Elizabethton, TN 37643-2938 |
| Melanie Hagerman | Nurse Practitioner | Blue Ridge Medical Management Corporation | 2 Professional Park Dr, Suite 11, Johnson City, TN 37604-6584 |
| Jessica Glasscock Mcgahey | Nurse Practitioner | Blue Ridge Medical Management Corporation | 400 N State of Franklin, Room Lk015, Johnson City, TN 37604-0000 |
| Amanda Elizabeth Loughlin | Nurse Practitioner | Blue Ridge Medical Management Corporation | 71 S Flannagan Ave, Lebanon, VA 24266 |
| Adam Horn | Nurse Practitioner | Blue Ridge Medical Management Corporation | 403 N State of Franklin Rd, Johnson City, TN 37604-0000 |
| Street Address |
2000 BROOKSIDE DR SUITE 3 |
| City | KINGSPORT |
| State | TN |
| Zip | 37660-4627 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert J Netherland | Nurse Practitioner | Blue Ridge Medical Management Corporation | 2000 Brookside Dr, Kingsport, TN 37660-4627 |
| David W Hale Jr. | Emergency Medicine | Tri-cities Regional Emergency Physicians, PC | 2000 Brookside Dr, Kingsport, TN 37660-4627 |
| Ardel Gorospe | Family Medicine | Blue Ridge Medical Management Corporation | 2000 Brookside Dr, Suite 3, Kingsport, TN 37660-4627 |
| Patricia L Penley | Nurse Practitioner | Tri-cities Regional Emergency Physicians, PC | 2000 Brookside Dr, Kingsport, TN 37660-4627 |
| Matthew P Riggins | Emergency Medicine | Tri-cities Regional Emergency Physicians, PC | 2000 Brookside Dr, Kingsport, TN 37660-4627 |
| Drew P Mcfarland Iv | Emergency Medicine | Tri-cities Regional Emergency Physicians, PC | 2000 Brookside Dr, Kingsport, TN 37660-4627 |
| Debra J Price | Emergency Medicine | Tri-cities Regional Emergency Physicians, PC | 2000 Brookside Dr, Kingsport, TN 37660-4627 |
| Amanda Genco | Nurse Practitioner | Tri-cities Regional Emergency Physicians, PC | 2000 Brookside Dr, Kingsport, TN 37660-4627 |
| Mark Andrew Mccommons | Internal Medicine | Blue Ridge Medical Management Corporation | 2000 Brookside Dr, Suite 3, Kingsport, TN 37660-4627 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lucinda Miller | Critical Care (intensivists) | Wellmont Medical Associates Inc | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 |
| Daniel D Carroll | Family Medicine | Wellmont Medical Associates Inc | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 |
| Wendy Vogel | Nurse Practitioner | Wellmont Medical Associates Inc | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 |
| Jennifer Leigh Cox | Nurse Practitioner | Wellmont Medical Associates Inc | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 |
| Marsha G Rose | Clinical Social Worker | 2005 Venture Park, Kingsport, TN 37660-1098 | |
| Shelley Hilton | Nurse Practitioner | Dermatology Associates of Kingsport, P.C. | 2300 W Stone Dr, Kingsport, TN 37660-2360 |
| Hannah Ruth Cook | Physician Assistant | Dermatology Associates of Kingsport, P.C. | 2300 W Stone Dr, Kingsport, TN 37660-2360 |
| Carri Beth Homoky | Dermatology | Dermatology Associates of Kingsport, P.C. | 2300 W Stone Dr, Kingsport, TN 37660-2360 |
| Joni Glavan Sago | Dermatology | Dermatology Associates of Kingsport, P.C. | 2300 W Stone Dr, Kingsport, TN 37660-2360 |
| Darrell Ray Millsap | Physician Assistant | Dermatology Associates of Kingsport, P.C. | 2300 W Stone Dr, Kingsport, TN 37660-2360 |
| Find all physicians in zip 37660 | |||
| City | KINGSPORT |
| Zip Code | 37660 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | KINGSPORT + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Shasta Nicole Bowens.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.