Individual provider Active NPI

Tiffany Ann Fowler, CNM

  • Advanced Practice Midwife
  • Conway, SC
National Provider Identifier
1366001752
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Practice address
2376 Cypress Cir Ste 200
Conway, SC 29526-8994
Phone
(843) 347-7216
NPI assigned
Jun 10, 2019
Last updated
Aug 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X NU Primary

Addresses

Primary practice location

2376 Cypress Cir Ste 200
Conway, SC 29526-8994

Mailing address

300 Singleton Ridge Rd
Attention PNS Credentialing
Conway, SC 29526-9142
Phone (843) 234-6946

Other practice location 1

5010 Carolina Forest Blvd
Myrtle Beach, SC 29579-3579
Phone (843) 903-1010

Other practice location 2

6010 Highway 707, Ste 300
Myrtle Beach, SC 29588-7321
Phone (843) 347-7216

Other practice location 3

620 Singleton Ridge Rd
Conway, SC 29526-9154
Phone (843) 347-7216

Other identifiers 1

IdentifierTypeStateIssuer
MW0265MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230518003531 NC Practitioner - Certified Nurse Midwife (CNM) 9638409469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbus Regional Health NetworkGroup PAC ID 6608924931, 48 clinicians

Practice addresses (Care Compare)

14508 James B White Hwy S
Tabor City, NC 28463-8358
Phone (910) 642-5832

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Regional Health Network Current Accepting new patients
Columbus Regional Health Network CurrentSince Apr 24, 2023 Accepting new patients
Columbus Regional Health Network CurrentSince Apr 24, 2023 Accepting new patients

Locations

14508 James B White Hwy S
Tabor City, NC 28463
Phone (910) 641-8680

619 Jefferson St
Whiteville, NC 28472
Phone (910) 642-0331

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1366001752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "address_2": "ATTENTION PNS CREDENTIALING",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-234-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2376 CYPRESS CIR STE 200",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268994",
            "telephone_number": "843-347-7216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5010 Carolina Forest Blvd",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295793579",
            "country_code": "US",
            "telephone_number": "843-903-1010",
            "fax_number": "843-903-1015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6010 Highway 707, Ste 300",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295887321",
            "country_code": "US",
            "telephone_number": "843-347-7216",
            "fax_number": "843-347-7218",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 Singleton Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "SC",
            "postal_code": "295269154",
            "country_code": "US",
            "telephone_number": "843-347-7216",
            "fax_number": "843-347-7218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "TIFFANY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MW0265",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

Verify at the official NPI Registry.