Individual provider Active NPI

Daniel Peter Fowler, MD

  • Plastic Surgery Physician
  • Knoxville, TN
National Provider Identifier
1154582450
Registry record updated Apr 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
51508 Issued in TN
Practice address
9111 Cross Park Dr Ste D200
Knoxville, TN 37923-4521
Phone
(865) 470-4127
Fax
(833) 790-3693
NPI assigned
Jun 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 51508 TN Primary

Addresses

Primary practice location

9111 Cross Park Dr Ste D200
Knoxville, TN 37923-4521

Mailing address

1558 Kenesaw Ave
Knoxville, TN 37919-7861
Phone (865) 308-2255

Other identifiers 1

IdentifierTypeStateIssuer
Q008038MedicaidTN

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
I20141006001156 TN Practitioner - Plastic and Reconstructive Surgery 4981838562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Tennessee, HSC, College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knoxville Center for Dermatology and Plastic Surgery PLGroup PAC ID 9436406717, 3 clinicians

Practice addresses (Care Compare)

9430 Park W Blvd
Suite 240
Knoxville, TN 37923-4204
Phone (865) 470-4127

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.05 of 100Reported as group
Quality
100
Improvement activities
40
Cost
56.83

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision91
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51508TNMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee Plastic Surgery,P.C. Plastic Surgery CurrentSince Jun 1, 2018 Accepting new patients
Knoxville Center for Dermatology and Plastic Surgery, PL CurrentSince Jun 1, 2018 Accepting new patients
Allergy Associates, P.a. Past Accepting new patients

Locations

9111 Cross Park Dr
Ste D200
Knoxville, TN 37923
Phone (865) 470-4206

4319 Papermill Dr
Knoxville, TN 37909
Phone (865) 470-4127

9430 Park West Blvd
Ste 240
Knoxville, TN 37923
Phone (865) 470-4127

Organizations & group practices 3

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 2

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": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522627200000",
    "number": "1154582450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1558 KENESAW AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379197861",
            "telephone_number": "865-308-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9111 CROSS PARK DR STE D200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234521",
            "telephone_number": "865-470-4127",
            "fax_number": "833-790-3693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "DANIEL",
        "middle_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-19",
        "last_updated": "2018-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TN",
            "license": "51508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q008038",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.