Individual provider Active NPI

Ann Fowler, ARNP

  • Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1194775148
Registry record updated Oct 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
FLARNP9206680 Issued in FL
Practice address
12670 Whitehall Dr
Fort Myers, FL 33907-3619
Phone
(239) 936-3554
Fax
(239) 936-8993
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X FLARNP9206680 FL Primary

Addresses

Primary practice location

12670 Whitehall Dr
Fort Myers, FL 33907-3619

Mailing address

12670 Whitehall Dr
Fort Myers, FL 33907-3619
Phone (239) 936-3554

Other identifiers 1

IdentifierTypeStateIssuer
306206600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040612000033 FL Practitioner - Nurse Practitioner 9335122035 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
FLARNP9206680FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Neurology Group P L CurrentSince Nov 1, 2013 Accepting new patients

Locations

12670 Whitehall Dr
Fort Myers, FL 33907
Phone (239) 936-3554

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383177600000",
    "number": "1194775148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12670 WHITEHALL DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073619",
            "telephone_number": "239-936-3554",
            "fax_number": "239-936-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12670 WHITEHALL DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073619",
            "telephone_number": "239-936-3554",
            "fax_number": "239-936-8993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "ANN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2013-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "FLARNP9206680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306206600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.