Kimberly Dawn Fowler

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

104760 Issued in TX

Practice address

4011 Benbrook Hwy Ste C
Ft Worth, TX 76116-7800

Phone

(817) 386-5500

NPI assigned

Oct 28, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Cowtown Pediatrix Clinic, LLC

  • Multi-Specialty Clinic/Center
  • Fort Worth, TX
  • NPI 1821489121
  NPD

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

{
    "created_epoch": "1319760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1366728883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 W ROCK ISLAND AVE",
            "city": "BOYD",
            "state": "TX",
            "postal_code": "760233103",
            "telephone_number": "256-341-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 BENBROOK HWY STE C",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761167800",
            "telephone_number": "817-386-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5316 Trail Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761331931",
            "country_code": "US",
            "telephone_number": "817-292-8787",
            "fax_number": "817-789-6489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-28",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "104760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149984001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207164901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fouroakshealth LLC
• Cynthia Foutz, LVN
• Thomas Fow, DDS
• Amy Fowler, LPC
• Heather Fowler, LMSW
• Michael Fowler, LMFT
• Tammie M Fowler
• Fox Clinic Investments, LLC
• Chloe Fox, LMSW
• Heather Fox

• Speech-Language Pathologist in Ft Worth, TX
• Providers in Ft Worth, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.