Shannon Marie Fowler, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

1-113275 Issued in AL

Practice address

1038 Research Blvd
Madison, AL 35758-2069

Phone

(205) 379-0174

NPI assigned

Nov 8, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Shannon Marie Higginbotham Former name

Medicare fee-for-service enrollment

Enrolled in AL, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Advantage Family Care Inc

  • Urgent Care Clinic/Center
  • Florence, AL
  • NPI 1023447943
  Medicare reassignment NPD
• Emergency Physicians Group

  • Emergency Medicine Physician
  • Huntsville, AL
  • NPI 1659366649
  Medicare reassignment NPD
• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865
  Medicare reassignment NPD
• Alh Hospitalist

  • Hospitalist Physician
  • Athens, AL
  • NPI 1770992398
  Medicare reassignment
• Advantage Family Care, Inc.

  • Rural Health Clinic/Center
  • Athens, AL
  • NPI 1518674936
  NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Flexcare Infusion Okc, LLC

  • Infusion Therapy Clinic/Center
  • Oklahoma City, OK
  • NPI 1013480490
  NPD (past)
• Physicians Medical Care

  • Health Service Clinic/Center
  • Murfreesboro, TN
  • NPI 1588851661
  NPD (past)

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

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1134764608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27717 KOSAR XING",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356137606",
            "telephone_number": "256-777-2620",
            "fax_number": "256-265-7017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1038 RESEARCH BLVD",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357582069",
            "telephone_number": "205-379-0174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27717 Kosar Xing",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "AL",
            "postal_code": "356137606",
            "country_code": "US",
            "telephone_number": "256-777-2620",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1321 Huntsville Hwy",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "TN",
            "postal_code": "373343603",
            "country_code": "US",
            "telephone_number": "931-297-2201",
            "fax_number": "931-297-2206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-08",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "113275",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "32107",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-113275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134764608",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "HIGGINBOTHAM",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Acute Care Nurse Practitioner in Madison, AL
• Providers in Madison, AL by specialty
• Acute Care Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.