Individual provider Active NPI

Russell Fowler, D.C.

  • Chiropractor
  • Springfield, MO
National Provider Identifier
1124194519
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7087 Issued in AZ
Practice address
1675 E Seminole St
Suite H2
Springfield, MO 65804-2490
Phone
(417) 881-2295
Fax
(417) 881-4282
NPI assigned
Nov 28, 2006
Last updated
Feb 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7087 AZ Primary
Chiropractor 111N00000X 20144016190 MO

Addresses

Primary practice location

1675 E Seminole St
Suite H2
Springfield, MO 65804-2490

Mailing address

PO Box 10182
Springfield, MO 65808-0182
Phone (602) 373-5115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140627000286 MO Practitioner - Chiropractic 2961455001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1675 E Seminole St
Suite H
Springfield, MO 65804-2490
Phone (417) 881-2295

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
20144016190MOMDChiropractor
7087AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Russell Fowler LLC Chiropractor CurrentSince Dec 11, 2008 Accepting new patients
Harris Chiropractic LLC Chiropractor Past Accepting new patients
Podolak Chiropractic Center LLC Past Accepting new patients
Fred Schofield PC Chiropractor PastSince Nov 19, 2007 Accepting new patients

Locations

4550 E Bell Rd
Ste 152
Phoenix, AZ 85032
Phone (602) 258-9663

4727 E Bell Rd
Ste 45
Phoenix, AZ 85032

1675 E Seminole St
Ste H
Springfield, MO 65804
Phone (417) 881-2295

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455753600000",
    "number": "1124194519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10182",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658080182",
            "telephone_number": "602-373-5115",
            "fax_number": "417-881-4282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 E SEMINOLE ST",
            "address_2": "SUITE H2",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042490",
            "telephone_number": "417-881-2295",
            "fax_number": "417-881-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "RUSSELL",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2016-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7087",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "20144016190",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.