NPIMap

Individual provider Active NPI

Susan Marie Daugharty Fowler, MD

  • Internal Medicine Physician
  • Coeur Dalene, ID
National Provider Identifier
1073648945
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M5531 Issued in ID
Practice address
2207 Ironwood PL
Coeur Dalene, ID 83814
Phone
(208) 667-1200
Fax
(208) 667-3994
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M5531 ID Primary

Addresses

Primary practice location

2207 Ironwood PL
Coeur Dalene, ID 83814

Mailing address

2207 Ironwood PL
Coeur Dalene, ID 83814
Phone (208) 667-1200

Other practice location 1

1919 Lincoln Way Ste 110
Coeur D Alene, ID 83814-2527
Phone (208) 625-4515

Other identifiers 1

IdentifierTypeStateIssuer
002391000MedicaidID

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address susan.daughartyfowler.p79@direct.kootenai.nextgenshare.com
Direct Messaging Address sdaughartyfowler609792@direct.multicare.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080828000315 ID Practitioner - Internal Medicine 4385710367 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Washington School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kootenai Health IncGroup PAC ID 1355792276, 394 clinicians

Practice addresses (Care Compare)

1055 Riverside Ave
Orofino, ID 83544-9029
Phone (208) 476-5777

1919 Lincoln Way
Coeur D Alene, ID 83814-2527

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

Hospital & facility affiliations

  • North Idaho Home Health Home health agency, Coeur D Alene, ID, CCN 137019
  • Eden Home Health Home health agency, Ponderay, ID, CCN 137122
  • Ahc Home Health of Coeur D Alene LLC Home health agency, Coeur D'Alene, ID, CCN 137130
  • Reliant Healthcare, Inc Home health agency, Coeur D'Alene, ID, CCN 137126
  • Hospice of North Idaho Hospice, Coeur D Alene, ID, CCN 131504
  • Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049
  • Bonner General Hospital Hospital, Sandpoint, ID, CCN 131328
  • Benewah Community Hospital Hospital, Saint Maries, ID, CCN 131317
  • Shoshone Medical Center Hospital, Kellogg, ID, CCN 131314
  • Northwest Specialty Hospital Hospital, Post Falls, ID, CCN 130066

Merit-based Incentive Payment System (MIPS)

Final score
86.65 of 100Reported as apm
Quality
89.26
Promoting interoperability
69.9
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M5531IDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kootenai Health, Inc. CurrentSince May 1, 2014 Accepting new patients
Kootenai Health, Inc. CurrentSince May 1, 2014 Accepting new patients
Incyte Pathology, PLLC Current Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

1919 Lincoln Way
Ste 110
Coeur D Alene, ID 83814
Phone (208) 625-4515

2207 N Ironwood Pl
#0
Coeur D Alene, ID 83814

2207 N Ironwood Pl
Coeur D Alene, ID 83814
Phone (208) 625-5085

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

1300 E Mullan Ave
Ste 700
Post Falls, ID 83854
Phone (208) 625-5564

Interoperability endpoints

  • Direct secure messaging: susan.daughartyfowler.p79@direct.kootenai.nextgenshare.com

Organizations & group practices 5

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 12

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1073648945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2207 IRONWOOD PL",
            "city": "COEUR DALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-667-1200",
            "fax_number": "208-667-3994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2207 IRONWOOD PL",
            "city": "COEUR DALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-667-1200",
            "fax_number": "208-667-3994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 Lincoln Way Ste 110",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838142527",
            "country_code": "US",
            "telephone_number": "208-625-4515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAUGHARTY FOWLER",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M5531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002391000",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "susan.daughartyfowler.p79@direct.kootenai.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1919 Lincoln Way Ste 110",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838142527",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdaughartyfowler609792@direct.multicare.org",
            "affiliation": "N",
            "address_1": "1919 Lincoln Way Ste 110",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838142527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coeur Dalene, ID

Sources for this page

Verify at the official NPI Registry.