Cody Fowler, P.A.-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA-1326 Issued in ID

Practice address

3345 Potomac Way
Idaho Falls, ID 83404-4978

Phone

(208) 552-7572

Fax

(208) 552-7312

NPI assigned

Nov 19, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Idaho Physician Services IncGroup PAC ID 2163430943, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018
• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Idaho Physician Services Inc.

  dba East Falls Orthopedics

  • Orthopaedic Surgery Physician
  • Idaho Falls, ID
  • NPI 1902841893
  Medicare reassignment Care Compare group

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

• Eastern Idaho Health Services Inc

  dba Eastern Idaho Regional Medical Center

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1225082209
  Care Compare affiliation
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1386018950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277381",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303847381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3345 POTOMAC WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834044978",
            "telephone_number": "208-552-7572",
            "fax_number": "208-552-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "CODY",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-19",
        "last_updated": "2022-02-08",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ID",
            "license": "PA-1326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CODY.FOWLER@hca3.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "3345 Potomac Way",
            "city": "Idaho Falls",
            "state": "ID",
            "country_code": "US",
            "postal_code": "834044978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• For Your Eyes Only, LLC
• Ashley N Ford, D.O.
• Forrester Academy, Inc. (Alturas International Academy)
• John Gregory Foster, CRNA
• Allen J Fowler, ADC
• Tailer Paige Fowler
• Melanie Francis
• Justin Frandsen, DDS
• Aaron Mart Frazier Jr.
• Fred Meyer Stores Inc (Fred Meyer Pharmacy)

• Surgical Physician Assistant in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Surgical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.