Phillip Patrick Fowler, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2539 Issued in AR

Practice address

2100 E Highland Dr Ste 100
Jonesboro, AR 72401-5144

Phone

(870) 972-6040

NPI assigned

Jul 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AR

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

Southern College of Optometry, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elite Eye Care and Optical LLCGroup PAC ID 7416053368, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Elite Eye Care & Optical LLC

  • Optometrist
  • Jonesboro, AR
  • NPI 1386795094
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1366456972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 S OLIVE ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037607",
            "telephone_number": "870-761-4761",
            "fax_number": "870-761-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E HIGHLAND DR STE 100",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015144",
            "telephone_number": "870-972-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "PHILLIP",
        "middle_name": "PATRICK",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152051722",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00073866",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI MEDICAID",
            "identifier": "318407004",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Desiree Fowler, LPC
• Dianna Fowler
• Holley Aleece Fowler
• Megan Fowler, MCD, CF-SLP
• Natasha Brooke Fowler, LPC
• Tina Fowler, LCSW
• Fox-Trot Therapy Services, Inc
• Taylor Briann Fox, LPN
• FPM Holdings LLC
• Lesley Rochelle Franco

• Optometrist in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.