Active NPI
Karen Fowles, RD
- Registered Dietitian
- Anchorage, AK
National Provider Identifier
1104041581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 171
- Practice address
- 4320 Diplomacy Drive PCC-Hed
Anchorage, AK 99508 - Phone
- (907) 729-8859
- NPI assigned
- Apr 13, 2007
- Last updated
- Oct 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 171 | AK | Primary |
Addresses
Primary practice location
4320 Diplomacy Drive PCC-Hed
Anchorage, AK 99508
Mailing address
11946 Regency Dr
Eagle River, AK 99577-7710
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DT5951 | Medicaid | AK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 171 | AK | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191888000000",
"number": "1104041581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11946 REGENCY DR",
"city": "EAGLE RIVER",
"state": "AK",
"postal_code": "995777710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4320 DIPLOMACY DRIVE PCC-HED",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "99508",
"telephone_number": "907-729-8859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLES",
"first_name": "KAREN",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-13",
"last_updated": "2007-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AK",
"license": "171",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DT5951",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.