Koby Douglas Fowler, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2106 Issued in CT

Practice address

1095 West St Unit 1
Southington, CT 06489

Phone

(860) 620-1705

Fax

(860) 620-1746

NPI assigned

Mar 9, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Modern Chiropractic of Newington LLC

  • Chiropractor
  • Newington, CT
  • NPI 1942700364
  NPD

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1104329887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 WEST ST UNIT 1",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064891023",
            "telephone_number": "860-620-1705",
            "fax_number": "860-620-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 WEST ST UNIT 1",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "06489",
            "telephone_number": "860-620-1705",
            "fax_number": "860-620-1746"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Berlin Tpke",
            "address_purpose": "LOCATION",
            "city": "Newington",
            "state": "CT",
            "postal_code": "061113206",
            "country_code": "US",
            "telephone_number": "860-667-8334 x402",
            "fax_number": "860-760-6456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "KOBY",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-09",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "2106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Fontaine
• Matthew Fontaine
• Jeana Forant, DC
• Stephanie Foresi
• Rodger Ernest Foster, D.V.M.
• Jolanta B Frano
• Sari K Friedman, M.D.
• Seva Galanis, LCSW, LADC
• Taylor O Gallimore, LCSW
• Gwynetta Gallup

• Chiropractor in Southington, CT
• Providers in Southington, CT by specialty
• Chiropractor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.