Individual provider Active NPI

Hyman Louis Fowler Jr., PA-C

  • Physician Assistant
  • Concord, NC
National Provider Identifier
1447598750
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-03951 Issued in NC
Practice address
202D McGill Ave NW
Concord, NC 28025
Phone
(704) 792-2242
NPI assigned
Jan 21, 2013
Last updated
Aug 29, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-03951 NC Primary

Addresses

Primary practice location

202D McGill Ave NW
Concord, NC 28025

Mailing address

202D McGill Ave NW
Concord, NC 28025-4615
Phone (704) 792-2242

Other practice location 1

202D McGill Ave NW
Concord, NC 28025
Phone (704) 792-2242

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20130223000130 NC Practitioner - Physician Assistant 2365697380 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-03951NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cabarrus Rowan Community Health Centers, Inc. CurrentSince Jun 18, 2017 Accepting new patients
Cabarrus Rowan Community Health Centers, Inc. CurrentSince Jun 18, 2017 Accepting new patients
Ankle and Foot Surgical and Podiatry Clinic PA PastSince Aug 1, 2009 Accepting new patients
Cabarrus Rowan Community Health Centers, Inc. Past Accepting new patients

Locations

307 E Thom St
China Grove, NC 28023
Phone (704) 855-7611

202D McGill Ave NW
Concord, NC 28025
Phone (704) 792-2242

Interoperability endpoints

  • Direct secure messaging: hyman.fowler.1@12871.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1358726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1447598750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202D MCGILL AVE NW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254615",
            "telephone_number": "704-792-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202D MCGILL AVE NW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "28025",
            "telephone_number": "704-792-2242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "202D McGill Ave NW",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "28025",
            "country_code": "US",
            "telephone_number": "704-792-2242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "HYMAN",
        "middle_name": "LOUIS",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-21",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.