Individual provider Active NPI

Jeannine M Fowler, OD

  • Optometrist
  • Fort Myers, FL
National Provider Identifier
1376563460
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3888 Issued in FL
Practice address
13451 McGregor Blvd Ste 3
Fort Myers, FL 33919-5923
Phone
(239) 337-3937
Fax
(239) 433-3968
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3888 FL Primary

Addresses

Primary practice location

13451 McGregor Blvd Ste 3
Fort Myers, FL 33919-5923

Mailing address

13451 McGregor Blvd Ste 3
Fort Myers, FL 33919-5923
Phone (239) 337-3937

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070317000079 FL Practitioner - Optometry 8527161280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13451 McGregor Blvd
Suite 3
Fort Myers, FL 33919-5992
Phone (239) 337-3937

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fowler Eyecare PL Optometrist CurrentSince Jun 7, 2007 Accepting new patients

Locations

13451 McGregor Blvd
Ste 3
Fort Myers, FL 33919
Phone (239) 337-3937

13451 McGregor Blvd
Ste 13
Fort Myers, FL 33919

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279584000000",
    "number": "1376563460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13451 MCGREGOR BLVD STE 3",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339195923",
            "telephone_number": "239-337-3937",
            "fax_number": "239-433-3968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13451 MCGREGOR BLVD STE 3",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339195923",
            "telephone_number": "239-337-3937",
            "fax_number": "239-433-3968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "JEANNINE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2010-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.