Thomas D Fowlkes, M. D.

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

13406 Issued in MS

Practice address

1916 University Ave
Oxford, MS 38655-4114

Phone

(662) 281-1306

Fax

(662) 281-1326

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Region IV Mental Health Services

  • Community/Behavioral Health Agency
  • Booneville, MS
  • NPI 1699869537
  Medicare reassignment NPD
• Region IV Desoto County Pharmacy

  • Community/Retail Pharmacy
  • Hernando, MS
  • NPI 1689915423
  NPD
• Region IV Mental Health Services

  • Community/Behavioral Health Agency
  • Ripley, MS
  • NPI 1467671412
  NPD
• United Emergency Services, Inc.

  • Emergency Medicine Physician
  • Booneville, MS
  • NPI 1326007915
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1477649218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1093",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386551093",
            "telephone_number": "662-801-7508",
            "fax_number": "662-234-8531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 UNIVERSITY AVE",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386554114",
            "telephone_number": "662-281-1306",
            "fax_number": "662-281-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLKES",
        "first_name": "THOMAS",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "13406",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MS",
            "license": "13406",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "MS",
            "license": "13406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01508551",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN",
            "identifier": "5916714",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ben Phillips Fortner, BA, MS, JD
• Jamie Vice Fortner, FNP
• Portia L Fountain, MS CCC-SLP
• Ashley Nicole Fowler, BSW
• Brenda Lyle Fowler, D.D.S.
• Ariel Fox, BSW
• Cynthia Francis, MAC
• Jacob Franklin
• Leslie Frazier, PA-C
• Freds Stores of Tennessee Inc

• Addiction Medicine (Internal Medicine) Physician in Oxford, MS
• Providers in Oxford, MS by specialty
• Addiction Medicine (Internal Medicine) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.