Individual provider Active NPI

Marvelyn Ann Scott Fowler, LCSW-C

  • Clinical Social Worker
  • Bowie, MD
National Provider Identifier
1467755025
Registry record updated Jan 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
05364 Issued in MD
Practice address
3104 Eagles Nest Dr
Bowie, MD 20716-3917
Phone
(301) 741-0380
Fax
(301) 464-1939
NPI assigned
Dec 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 05364 MD Primary

Addresses

Primary practice location

3104 Eagles Nest Dr
Bowie, MD 20716-3917

Mailing address

3104 Eagles Nest Dr
Bowie, MD 20716-3917
Phone (301) 741-0380

Other names 1

  • Mrs. Marvelyn Ann Scott Fowler Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130117000325 MD Practitioner - Clinical Social Worker 4385897669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Andrew T Gergely, MD and Associates, LLCGroup PAC ID 1456323237, 16 clinicians

Practice addresses (Care Compare)

3175 W Ward Rd
Dunkirk, MD 20754-3024
Phone (410) 286-0664

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05364MDMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew T Gergely, MD & Associates, LLC CurrentSince Nov 1, 2012 Accepting new patients

Locations

3175 W Ward Rd
Ste 200
Dunkirk, MD 20754
Phone (410) 286-0664

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1292803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358726400000",
    "number": "1467755025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 EAGLES NEST DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163917",
            "telephone_number": "301-741-0380",
            "fax_number": "301-464-1939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 EAGLES NEST DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163917",
            "telephone_number": "301-741-0380",
            "fax_number": "301-464-1939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT FOWLER",
        "first_name": "MARVELYN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-20",
        "last_updated": "2013-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "05364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARVELYN",
            "last_name": "SCOTT FOWLER",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "LCSW-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.