Individual provider Active NPI

Chad Ryan Fowler, MD

  • Family Medicine Physician
  • Wentzville, MO
National Provider Identifier
1073609376
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2009012785 Issued in MO
Practice address
1032 Crosswinds CT
Wentzville, MO 63385
Phone
(844) 853-8937
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2009012785 MO Primary

Addresses

Primary practice location

1032 Crosswinds CT
Wentzville, MO 63385

Mailing address

1800 Community
Clinton, MO 64735-8804
Phone (660) 885-8131

Other practice location 1

550 Landmarks Blvd
Alton, IL 62002-6321
Phone (618) 463-5905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090805000313 MO Practitioner - Family Practice 4981665262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Compass Health IncGroup PAC ID 1951206754, 317 clinicians
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

1032 Crosswinds CT
Wentzville, MO 63385-4836
Phone (888) 403-1071

12445 Dorsett Rd
Maryland Heights, MO 63043-3907
Phone (314) 251-1820

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2009012785MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health, Inc CurrentSince Jan 1, 2019 Accepting new patients
Mercy Clinic East Communities Family Medicine CurrentSince Feb 2, 2026 Accepting new patients
Compass Health, Inc CurrentSince Jan 1, 2019 Accepting new patients
Physician Specialists of St Lukes LLC Family Medicine Past Accepting new patients

Locations

1800 Community
#B
Clinton, MO 64735

1800 Community
Clinton, MO 64735
Phone (660) 885-8131

12445 Dorsett Rd
Maryland Heights, MO 63043
Phone (314) 251-1820

102 Compass Point Dr
Saint Charles, MO 63301
Phone (636) 332-8318

3785 New Town Blvd
Saint Charles, MO 63301
Phone (636) 669-2332

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

8075 Mexico Rd
Saint Peters, MO 63376
Phone (573) 234-5258

101 Progress Pkwy
Sullivan, MO 63080
Phone (573) 468-3555

91 Troy Sq
Troy, MO 63379

1780 Old Highway 50 E
Ste 111
Union, MO 63084
Phone (636) 584-0305

19515 Brune Pkwy
Warrenton, MO 63383
Phone (636) 235-4049

1032 Crosswinds Ct
Wentzville, MO 63385
Phone (636) 332-6000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1073609376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 CROSSWINDS CT",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "63385",
            "telephone_number": "844-853-8937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Landmarks Blvd",
            "address_purpose": "LOCATION",
            "city": "Alton",
            "state": "IL",
            "postal_code": "620026321",
            "country_code": "US",
            "telephone_number": "618-463-5905",
            "fax_number": "618-463-5935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "CHAD",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2009012785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wentzville, MO

Sources for this page

Verify at the official NPI Registry.