NPIMap

Organization Active NPI

Fowler Enterprises Inc.

Doing business as East Mountain Physical Therapy

  • Physical Therapist
  • Cedar Crest, NM
National Provider Identifier
1467634469
Registry record updated Dec 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
FOWLER ENTERPRISES INC.
Doing business as
East Mountain Physical Therapy
Practice address
12127 B3 N. Hwy 14
Cedar Crest, NM 87008
Phone
(505) 286-3678
NPI assigned
Nov 30, 2007
Last updated
Dec 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2011

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

Authorized official

Name
Cheryl W Fowler, PTNPI 1518030287
Title
Owner/ Authorized Representative
Phone
(505) 220-6949

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

12127 B3 N. Hwy 14
Cedar Crest, NM 87008

Mailing address

PO Box 1730
Moriarty, NM 87035-1730
Phone (505) 832-4011

Other identifiers 1

IdentifierTypeStateIssuer
08028079MedicaidNM

Other names 1

  • East Mountain Physical Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
East Mountain Physical Therapy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12127 N Highway 14
#B3
Cedar Crest, NM 87008
Phone (505) 286-3678

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323388800000",
    "number": "1467634469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1730",
            "city": "MORIARTY",
            "state": "NM",
            "postal_code": "870351730",
            "telephone_number": "505-832-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12127 B3 N. HWY 14",
            "city": "CEDAR CREST",
            "state": "NM",
            "postal_code": "87008",
            "telephone_number": "505-286-3678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOWLER ENTERPRISES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2011-12-09",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/ AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "505-220-6949",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08028079",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Mountain Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Crest, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.