NPIMap

Individual provider Active NPI

Jennifer Leigh Fowler, APRN

  • Gerontology Nurse Practitioner
  • Easley, SC
National Provider Identifier
1083362198
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
24963 Issued in SC
Practice address
105 Franklin Square Way Ste a
Easley, SC 29642-3715
Phone
(864) 442-4110
Fax
(864) 442-4126
NPI assigned
Mar 17, 2022
Last updated
Sep 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 24963 SC Primary

Addresses

Primary practice location

105 Franklin Square Way Ste a
Easley, SC 29642-3715

Mailing address

477 Cresthaven Dr
Boiling SPGS, SC 29316-5766
Phone (864) 978-7069

Other practice location 1

1123 Spring St
Greenwood, SC 29646-3833
Phone (864) 450-9036

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jennyleighfowler@outlook.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20220404000078 SC Practitioner - Nurse Practitioner 6002202967 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians

Practice addresses (Care Compare)

1123 Spring St
Greenwood, SC 29646-3833
Phone (864) 450-9036

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
24963SCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Self Medical Group CurrentSince Oct 30, 2023 Accepting new patients
Self Regional Healthcare CurrentSince Sep 24, 2025 Accepting new patients
Self Regional Healthcare Current Accepting new patients
PH Healthcare Services, Inc. CurrentSince Aug 21, 2023 Accepting new patients
Self Medical Group CurrentSince Oct 30, 2023 Accepting new patients
Self Regional Healthcare CurrentSince Sep 24, 2025 Accepting new patients
Self Medical Group Current Accepting new patients
PH Health Care Services Inc PastSince May 7, 2024 Accepting new patients
Self Regional Healthcare Past Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

75 Remittance Dr
Dept 6793
Chicago, IL 60675

1123 Spring St
Greenwood, SC 29646
Phone (864) 450-8036

155 Academy Ave
Greenwood, SC 29646
Phone (864) 725-4865

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

102 R L Sawyer Md Dr
Saluda, SC 29138
Phone (864) 445-2173

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: jfowler541194@selfregional.direct-ci.net

Organizations & group practices 9

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

Hospital & facility affiliations 7

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": "1647475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1083362198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 CRESTHAVEN DR",
            "city": "BOILING SPGS",
            "state": "SC",
            "postal_code": "293165766",
            "telephone_number": "864-978-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 FRANKLIN SQUARE WAY STE A",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296423715",
            "telephone_number": "864-442-4110",
            "fax_number": "864-442-4126"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1123 Spring St",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "SC",
            "postal_code": "296463833",
            "country_code": "US",
            "telephone_number": "864-450-9036",
            "fax_number": "864-450-9038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-17",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "24963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennyleighfowler@outlook.com",
            "affiliation": "N",
            "endpointDescription": "personal email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "105 Franklin Square Way Ste A",
            "city": "Easley",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296423715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Easley, SC

Sources for this page

Verify at the official NPI Registry.