BOWIE STATE UNIVERSITY
NPI 1154888048
Nurse Practitioner - Adult Health in Bowie, MD

Q: What is Bowie State University's NPI number?

The NPI number for Bowie State University is 1154888048. It was assigned to this organization in the NPPES registry on February 27, 2019. The provider is also known as Henry Wise Wellness Center.

Q: What is Bowie State University's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Active since February 27, 2019CLIA 21D1045748 · Microscopy

14000 JERICHO PARK ROAD, HENRY WISE WELLNESS CENTER, CMRC, LOWER LEVEL, BOWIE, MD 20715(301) 860-4170(601) 860-4179 Get Directions Write a Review

NPPES record last updated: February 27, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Bowie State University NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOWIE STATE UNIVERSITY (NPI 1154888048) is a healthcare organization registered as an adult health in Bowie, Maryland and active in the NPI registry since February 2019. The organization holds a CLIA Microscopy certificate valid through December 4, 2026 and lists Artie Lee Travis, Vice President Student Affairs, as its authorized official.

NPPES Registry Identity

NPI1154888048

Entity TypeOrganization

Primary Taxonomy363LA2200X

Legal Business NameBOWIE STATE UNIVERSITY

Location Address14000 JERICHO PARK ROAD, HENRY WISE WELLNESS CENTER, CMRC, LOWER LEVELBowie, MD 20715

Mailing Address14000 Jericho Park Road, Henry Wise Wellness Center, Cmrc, Lower LevelBowie, MD 20715 · (301) 860-4170 · Fax (601) 860-4179

Phone(301) 860-4170

Fax(601) 860-4179

Organization SubpartYes

Authorized OfficialArtie Lee TravisVice President Student Affairs · (301) 860-3390

Enumeration DateFebruary 27, 2019

✔ NPI 1154888048 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

Also ListedPhlebologyTaxonomy 202K00000X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedNurse Practitioner · Obstetrics & GynecologyTaxonomy 363LX0001X

14000 JERICHO PARK ROAD, Bowie, MD 20715

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Other Names 1

Other NameHenry Wise Wellness Center

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 21D1045748

Bowie State University Wellness Center · Bowie, MD

Active · expires Dec 4, 2026

CLIA Number21D1045748

Laboratory TypeSchool/Student Health Service

Certificate Effective DateDecember 5, 2024

Certificate Expiration DateDecember 4, 2026

Laboratory DirectorLi Lin Chiu

Laboratory Phone(301) 860-4177

Laboratory LocationBowie State University Wellness Center14000 Jericho Park Road Crmc Ll, Bowie, MD 20715

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VARSITY PROFESSIONAL REHABILITATION AND STAFFING, LLC

Physical Therapist (Sports)

14000 JERICHO PARK ROAD
BOWIE, MD 20715

Prince George's County (202) 277-7887

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bowie State University's NPI number?

The NPI number for Bowie State University is 1154888048. It was assigned to this organization in the NPPES registry on February 27, 2019. The provider is also known as Henry Wise Wellness Center.

Where is Bowie State University located?

Bowie State University is located at 14000 Jericho Park Road Henry Wise Wellness Center, Cmrc, Lower Level, Bowie, MD 20715. The listed phone number is (301) 860-4170.

What is Bowie State University's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Does Bowie State University hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 21D1045748) is associated with this NPI, valid through December 4, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bowie State University was last updated on February 27, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.