Individual provider Active NPI

Mark W Fowler, M.D.

  • Family Medicine Physician
  • Union City, TN
National Provider Identifier
1144200965
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34403 Issued in TN
Practice address
1020 Reelfoot Ave
Union City, TN 38261-5801
Phone
(731) 885-5131
Fax
(731) 885-5335
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34403 TN Primary

Addresses

Primary practice location

1020 Reelfoot Ave
Union City, TN 38261-5801

Mailing address

1020 Reelfoot Ave
Union City, TN 38261-5801
Phone (731) 885-5131

Other identifiers 2

IdentifierTypeStateIssuer
3854767MedicaidTN
080171892OtherTNRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050728001096 TN Practitioner - Family PracticePractitioner - General Practice 7810925179 Reassigns benefits to 2 organizations
Practice locations: Gallaway, TN; Martin, TN; Union City, TN

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
University of Tennessee, HSC, College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crossroads Urgent Care PLLCGroup PAC ID 8325117484, 181 clinicians
Armour Family Medicine, PLLCGroup PAC ID 7012057854, 7 clinicians

Practice addresses (Care Compare)

15 Old Humboldt Rd
Suite D
Jackson, TN 38305-3506
Phone (731) 256-6456

2445 Memorial Blvd
Suite C
Murfreesboro, TN 37129-5156
Phone (615) 217-6900

397 New Byhalia Rd
Collierville, TN 38017-3705
Phone (901) 860-0536

728 W Sherrod Ave
Covington, TN 38019-3024
Phone (901) 857-2296

7860 Wolf River Blvd
Germantown, TN 38138-1712
Phone (901) 390-4300

Hospital & facility affiliations

  • Gentiva Hospice, Nashville, TN, CCN 441545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34403TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
45 Urgent Care, P.C. Family Medicine CurrentSince Sep 1, 2014 Accepting new patients
Crossroads Urgent Care PLLC Family Medicine CurrentSince Jun 1, 2013 Accepting new patients
Crossroads Urgent Care PLLC Family Medicine CurrentSince Jun 1, 2013 Accepting new patients
Rebecca a. Griggs Past Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Bolivar General Hospital, Inc. Past Accepting new patients
Arlington Family Medical and Wellness Center PC PastSince Jun 19, 2012 Accepting new patients
Baptist Memorial Hospital-Tipton Past Accepting new patients
Emergency Coverage, LLC Family Medicine Past Accepting new patients
Bolivar General Hospital, Inc. Past Accepting new patients

Locations

149 N Star Dr
Jackson, TN 38305
Phone (731) 499-8634

2012 Greystone Sq
Jackson, TN 38305
Phone (731) 664-6998

2445 Memorial Blvd
Ste C
Murfreesboro, TN 37129
Phone (615) 217-6900

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FBFJDD/Endpoint/FBFJDD

Organizations & group practices 11

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280361600000",
    "number": "1144200965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 REELFOOT AVE",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615801",
            "telephone_number": "731-885-5131",
            "fax_number": "731-885-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 REELFOOT AVE",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615801",
            "telephone_number": "731-885-5131",
            "fax_number": "731-885-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "MARK",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2010-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "34403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3854767",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080171892",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, TN

Sources for this page

Verify at the official NPI Registry.