Individual provider Active NPI

Lewis Jeffers Fowlkes, MD

  • Gynecology Physician
  • Birmingham, AL
National Provider Identifier
1174580062
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
8800 Issued in AL
Practice address
800 Saint Vincents Dr
Suite 500
Birmingham, AL 35205-1620
Phone
(205) 933-8334
Fax
(205) 933-8466
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 8800 AL Primary

Addresses

Primary practice location

800 Saint Vincents Dr
Suite 500
Birmingham, AL 35205-1620

Mailing address

800 Saint Vincents Dr
Suite 500
Birmingham, AL 35205-1620
Phone (205) 933-8334

Other identifiers 2

IdentifierTypeStateIssuer
51028977OtherALBCBS
28978MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8800ALMDGynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1174580062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SAINT VINCENTS DR",
            "address_2": "SUITE 500",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051620",
            "telephone_number": "205-933-8334",
            "fax_number": "205-933-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SAINT VINCENTS DR",
            "address_2": "SUITE 500",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051620",
            "telephone_number": "205-933-8334",
            "fax_number": "205-933-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLKES",
        "first_name": "LEWIS",
        "middle_name": "JEFFERS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "AL",
            "license": "8800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51028977",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28978",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.