Active NPI
Raymond D. Fowler, M.D.
- Anesthesiology Physician
- Homer, AK
National Provider Identifier
1104808070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 4624
- Practice address
- 4300 Bartlett St
South Penisula Hospital
Homer, AK 99603-7005 - Phone
- (907) 235-8101
- NPI assigned
- Nov 16, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 4624 | AK | Primary |
| Anesthesiology Physician | 207L00000X | 6970A | WY | |
| Anesthesiology Physician | 207L00000X | 30104 | AZ |
Addresses
Primary practice location
4300 Bartlett St
South Penisula Hospital
Homer, AK 99603-7005
Mailing address
40914 Crested Crane St
Homer, AK 99603-9465
Phone (907) 235-9440
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD46242 | 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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4624 | AK | MD | Anesthesiology Physician |
| 30104 | AZ | MD | Anesthesiology Physician |
| 6970A | WY | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chugach Anesthesia, LLC | Anesthesiology | Past | Accepting new patients |
| Alaska Spine Center, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Ambulatory Surgical Clinic/Center
- Anchorage, AK
- NPI 1093710717
-
- Anesthesiology Physician
- Anchorage, AK
- NPI 1093712358
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1104808070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40914 CRESTED CRANE ST",
"city": "HOMER",
"state": "AK",
"postal_code": "996039465",
"telephone_number": "907-235-9440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 BARTLETT ST",
"address_2": "SOUTH PENISULA HOSPITAL",
"city": "HOMER",
"state": "AK",
"postal_code": "996037005",
"telephone_number": "907-235-8101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLER",
"first_name": "RAYMOND",
"middle_name": "D.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-16",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "AK",
"license": "4624",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WY",
"license": "6970A",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "AZ",
"license": "30104",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MD46242",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Homer, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.