Cory Fowler, MSN, A.P.R.N., FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

7867102-4405 Issued in UT

Practice address

3650 N University Ave Ste 200
Provo, UT 84604-6658

Phone

(801) 375-7102

Fax

(801) 375-7102

NPI assigned

Jul 12, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 29, 2020 through Jan 29, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

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.

• Integrative Medical Associates

  • Family Medicine Physician
  • Provo, UT
  • NPI 1144453739
  NPD (past)

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1154807196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 N UNIVERSITY AVE STE 200",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046658",
            "telephone_number": "801-375-7102",
            "fax_number": "801-375-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 N UNIVERSITY AVE STE 200",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046658",
            "telephone_number": "801-375-7102",
            "fax_number": "801-375-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "CORY",
        "credential": "MSN, A.P.R.N., FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "7867102-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camille Curtis Foster, L.C.S.W
• David Madison Foster, CRNA
• Katherine Foster
• Marie Dian Foster, M.ED. SPS
• Tracie Dana Foster, APC
• Courtney Fowler, M.S., CCC-SLP
• Rachel Fowles
• Hayley Fox
• Jacquelyn Marie Fox, NP
• Madison Fox

• Family Nurse Practitioner in Provo, UT
• Providers in Provo, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.