Active NPI
Terrell E Fowler III, D.C
- Chiropractor
- Lake City, SC
National Provider Identifier
1205990066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1191
- Practice address
- 111 N Matthews Rd
Lake City, SC 29560-2309 - Phone
- (843) 374-8299
- NPI assigned
- Dec 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1191 | SC | Primary |
Addresses
Primary practice location
111 N Matthews Rd
Lake City, SC 29560-2309
Mailing address
111 N Matthews Rd
Lake City, SC 29560-2309
Phone (843) 374-8299
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Sherman College of Straight Chiropractic, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
PO Box
Suite 12118
Florence, SC 29504-2118
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1191 | SC | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205990066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 N MATTHEWS RD",
"city": "LAKE CITY",
"state": "SC",
"postal_code": "295602309",
"telephone_number": "843-374-8299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 N MATTHEWS RD",
"city": "LAKE CITY",
"state": "SC",
"postal_code": "295602309",
"telephone_number": "843-374-8299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLER",
"first_name": "TERRELL",
"middle_name": "E",
"name_suffix": "III",
"credential": "D.C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "SC",
"license": "1191",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake City, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.