Jeremy David Fowler, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1811DT Issued in KY

Practice address

12406 La Grange Rd Ste 202
Louisville, KY 40245-1904

Phone

(502) 243-3733

Fax

(502) 243-3734

NPI assigned

Jun 27, 2008

Last updated

Sep 27, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Indiana University - School of Optometry, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Harveyeye, PLLCGroup PAC ID 2769521194, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Derby City Eye Care, PLLC

  • Optometrist
  • Crestwood, KY
  • NPI 1528425444
  Medicare reassignment NPD Authorized official
• Harveyeye, PLLC

  • Optometrist
  • Louisville, KY
  • NPI 1790018034
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758931200000",
    "number": "1225290406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12406 LA GRANGE RD STE 202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402451904",
            "telephone_number": "502-243-3733",
            "fax_number": "502-243-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12406 LA GRANGE RD STE 202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402451904",
            "telephone_number": "502-243-3733",
            "fax_number": "502-243-3734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9412 Jonathan Pl",
            "address_purpose": "LOCATION",
            "city": "Crestwood",
            "state": "KY",
            "postal_code": "400148025",
            "country_code": "US",
            "telephone_number": "502-475-8272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "JEREMY",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2025-09-27",
        "certification_date": "2025-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003525A",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1811DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11875636",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100428530",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Destiney Nicole Fowler
• Gency Fowler, RN
• Grace Nicole Fowler, MD
• Jason Lee Fowler, P.T.
• Jennifer Rose Fowler
• Joseph F Fowler Jr., M.D.
• Kristin Kellen Fowler, MSPT
• Morgan Elizabeth Fowler, RD
• Phoenix K Fowler, LCSW
• Fox Access LLC

• Optometrist in Louisville, KY
• Providers in Louisville, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.