NPIMap

Individual provider Active NPI

John Terry Fowler, M.D.

  • Internal Medicine Physician
  • Beaumont, TX
National Provider Identifier
1528075348
Registry record updated Sep 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L2891 Issued in TX
Practice address
755 N 11TH St
Suite P-5200
Beaumont, TX 77702-1501
Phone
(409) 898-2994
Fax
(409) 899-5542
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L2891 TX Primary

Addresses

Primary practice location

755 N 11TH St
Suite P-5200
Beaumont, TX 77702-1501

Mailing address

755 N 11TH St
Suite P-5200
Beaumont, TX 77702-1501
Phone (409) 898-2994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040624001631 TX Practitioner - Internal Medicine 3779569421 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical Branch at Galveston, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaumont Internal Medicine and Geriatric Assoc.Group PAC ID 9032195789, 17 clinicians

Practice addresses (Care Compare)

755 N 11TH St
Suite P5200
Beaumont, TX 77702-1522
Phone 4098982994105

Hospital & facility affiliations

  • Harbor Home Health Home health agency, Beaumont, TX, CCN 679163
  • Accentcare Home Health of Texas Home health agency, Beaumont, TX, CCN 673115
  • Centerwell Home Health Home health agency, Beaumont, TX, CCN 678039
  • Gentiva Hospice, Beaumont, TX, CCN 451638
  • Christus Southeast Texas- St Elizabeth Hospital, Beaumont, TX, CCN 450034
  • Baptist Beaumont Hospital Hospital, Beaumont, TX, CCN 450346
  • Mount Carmel East & West Hospital, Columbus, OH, CCN 360035

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Physician Network CurrentSince Jun 1, 2021 Accepting new patients
Ahmad Medical PC Internal Medicine PastSince Mar 5, 2004 Accepting new patients

Locations

3555 Stagg Dr
Beaumont, TX 77701
Phone (409) 212-5922

3282 College St
#100
Beaumont, TX 77701
Phone (409) 212-7100

3080 College St
Beaumont, TX 77701
Phone (409) 212-5000

3070 College St
Ste 120
Beaumont, TX 77701
Phone (409) 835-2300

Interoperability endpoints

  • Direct secure messaging: john.fowler@bimga.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
GentivaBeaumont, TX, CCN 451638 Hospice Contracted Managing Employee Nov 5, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411344000000",
    "number": "1528075348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 N 11TH ST",
            "address_2": "SUITE P-5200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021501",
            "telephone_number": "409-898-2994",
            "fax_number": "409-899-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 N 11TH ST",
            "address_2": "SUITE P-5200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021501",
            "telephone_number": "409-898-2994",
            "fax_number": "409-899-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "JOHN",
        "middle_name": "TERRY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2014-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L2891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.