Cacyce Fowler
Individual provider Active NPI Family Nurse Practitioner · Reform, AL
NPI 1457774200 · NPPES record last updated Nov 13, 2019
Key facts
- NPI
- 1457774200
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 1-093244 (AL)
- Practice address
- 108 4TH Ave SW Ste a
Reform, AL 35481 - Phone
- (205) 375-6251
- NPI assigned
- Jan 30, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pickens County Primary Care, PC
Practice addresses (Care Compare)
108 4TH Ave SW
Suite a
Reform, AL 35481-8018
Phone (205) 375-6251
630 4TH St NW
Gordo, AL 35466-2587
Phone (205) 364-0284
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140331000488 | AL | Practitioner - Nurse Practitioner | 6406087774 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steve R Lovelady MD LLC | Current | Accepting new patients | |
| Pickens County Primary Care, PC | Current |
Accepting new patients | |
| Pickens County Primary Care PC | Current |
Accepting new patients | |
| SLCM LLC | Current |
Accepting new patients | |
| Pickens County Primary Care, PC | Current |
Accepting new patients | |
| Pickens County Primary Care, P.C | Current | Accepting new patients |
Locations
630 4th St NW
Gordo, AL 35466
Phone (205) 364-0284
4310 Watermelon Rd
Northport, AL 35473
Phone (205) 330-5266
815 7th Ave SW
Reform, AL 35481
Phone (205) 375-2438
205 4th Ave SE
Reform, AL 35481
Phone (205) 375-2304
108 4th Ave SW
Ste A
Reform, AL 35481
Phone (205) 242-0580
104 4TH Ave SW Ste a
Reform, AL 35481
108 4th Ave SW
Ste B
Reform, AL 35481
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1-093244 | AL | Yes |
Addresses
Primary practice location
108 4TH Ave SW Ste a
Reform, AL 35481
Mailing address
108 4TH Ave SW Ste a
Reform, AL 35481-8018
Phone (205) 375-6251
Other practice location 1
4310 Watermelon Rd
Northport, AL 35473
Phone (205) 330-5266
Other practice location 2
4310 Watermelon Rd
Northport, AL 35473
Phone (205) 330-5266
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A04122A | Other | AL | MEDICARE |
| 512-17004 | Other | AL | BCBS OF ALABAMA |
Other providers in Reform, AL
- Randa Corley
- Sheila Gail Dare
- Kendall Lewis Estes
- Fenton Chiropractic LLC
- James Fenton
- Christopher Quantril Gosa
- Growing in the Dark Counseling Services
- H &W Apothecary, Inc
- Kristin Hamner
- John Chad Harless
All providers in Reform, AL · Family Nurse Practitioner in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.