Organization Active NPI

Fowler Chiropractic Clinic, PC

  • Chiropractor
  • Pearl, MS
National Provider Identifier
1447438437
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1017 Issued in MS
Legal business name
FOWLER CHIROPRACTIC CLINIC, PC
Practice address
5230 Highway 80 E
Suite a
Pearl, MS 39208-8921
Phone
(601) 932-1070
NPI assigned
Feb 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Authorized official

Name
Dr. Christopher S. Fowler, DCNPI 1366554834
Title
Owner
Phone
(601) 932-1070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1017 MS Primary

Addresses

Primary practice location

5230 Highway 80 E
Suite a
Pearl, MS 39208-8921

Mailing address

PO Box 1526
Brandon, MS 39043-1526
Phone (601) 932-1070

Other identifiers 1

IdentifierTypeStateIssuer
09015998MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110302000191 MS Part B Supplier - Clinic/Group Practice 9133300775 Receives reassigned benefits from 2 practitioners
Practice locations: Pearl, MS

National Provider Directory

National Provider Directory

Locations

5230 Highway 80 E
Ste A
Pearl, MS 39208
Phone (601) 932-1070

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202169600000",
    "number": "1447438437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1526",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390431526",
            "telephone_number": "601-932-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 HIGHWAY 80 E",
            "address_2": "SUITE A",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392088921",
            "telephone_number": "601-932-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOWLER CHIROPRACTIC CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-01",
        "last_updated": "2008-02-05",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-932-1070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "1017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015998",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearl, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.