Christine Annmarie Davis-Fowler, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9102369 Issued in FL

Practice address

4410 W. Oakland Park Blvd
Lauderdale Lakes, FL 33313

Phone

(954) 533-5900

Fax

(954) 533-3005

NPI assigned

Dec 8, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Deleeuws Family Clinic

  • Family Medicine Physician
  • Dania Beach, FL
  • NPI 1700945243
  NPD (past)
• We Care Family Clinic Incorporated

  • Medical Physician Assistant
  • Lauderdale Lakes, FL
  • NPI 1447540315
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1366501009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "599 S FEDERAL HWY",
            "city": "DANIA BEACH",
            "state": "FL",
            "postal_code": "330044107",
            "telephone_number": "954-920-4911",
            "fax_number": "954-922-9308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 W. OAKLAND PARK BLVD",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "33313",
            "telephone_number": "954-533-5900",
            "fax_number": "954-533-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS-FOWLER",
        "first_name": "CHRISTINE",
        "middle_name": "ANNMARIE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shoshana Dahan, LCSW
• Daniel Kesden MD PA
• Racquel Natasha Daniels
• Edward Adrian Dauer, M.D.
• David Eugene, D.D.S, P.L.L.C
• Alyssa Davis, LMHC, CRC
• Yira Larissa De la Paz, M.D.
• Mirlotte Demesmin, PHARM D.
• Leot Frisch Densmore, LMHC
• Nerlande Desinord, APRN

• All providers in Lauderdale Lakes, FL
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; 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.

Verify at the official NPI Registry.