Active NPI
Michael Anthony Fowler, PAC MPAS
- Allergy & Immunology Physician
- Albany, GA
National Provider Identifier
1336229236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- 1860
- Practice address
- 105 Spanish Court
Albany, GA 31707 - Phone
- (229) 438-7100
- Fax
- (229) 438-9382
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | 1860 | GA | Primary |
Addresses
Primary practice location
105 Spanish Court
Albany, GA 31707
Mailing address
105 Spanish Court
Albany, GA 31707
Phone (229) 438-7100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1860 | GA | MD | Allergy & Immunology Physician |
Interoperability endpoints
- mfowler@aacoga.gwaydirect.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336229236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 SPANISH COURT",
"city": "ALBANY",
"state": "GA",
"postal_code": "31707",
"telephone_number": "229-438-7100",
"fax_number": "229-438-9382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 SPANISH COURT",
"city": "ALBANY",
"state": "GA",
"postal_code": "31707",
"telephone_number": "229-438-7100",
"fax_number": "229-438-9382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLER",
"first_name": "MICHAEL",
"middle_name": "ANTHONY",
"credential": "PAC MPAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "GA",
"license": "1860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, GA
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 enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.