Individual provider Active NPI

Mariecken Fowler, MD

  • Neurology Physician
  • Fort Myers, FL
National Provider Identifier
1548200116
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME146337 Issued in FL
Practice address
11215 Metro Pkwy Ste 1
Fort Myers, FL 33966-1206
Phone
(239) 208-2212
NPI assigned
Jun 8, 2006
Last updated
Jun 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Behavioral Neurology & Neuropsychiatry Physician 2084B0040X 0101238278 VA
Diagnostic Neuroimaging (Psychiatry & Neurology) Physician 2084D0003X 0101238278 VA
Neurology Physician 2084N0400X 2020035640 MO
Neurology Physician 2084N0400X 20637 NH
Neurology Physician 2084N0400X MD473597 PA
Neurology Physician 2084N0400X S9132 TX
Neurology Physician 2084N0400X 0101238278 VA
Neurology Physician 2084N0400X ME146337 FL Primary
Hospitalist Physician 208M00000X ME146337 FL

Addresses

Primary practice location

11215 Metro Pkwy Ste 1
Fort Myers, FL 33966-1206

Mailing address

11215 Metro Pkwy BLDG 3
Fort Myers, FL 33966-1206
Phone (239) 208-2212

Other practice location 1

630 Eaton Ave
Hamilton, OH 45013-2767
Phone (513) 867-2000

Other practice location 2

1101 26th St S
Great Falls, MT 59405-5161
Phone (406) 731-8888

Other practice location 3

125 Medical Cir
Suite A
Winchester, VA 22601-3300
Phone (540) 667-1828

Other practice location 4

1250 S Cedar Crest Blvd Ste 405
Allentown, PA 18103-6224
Phone (610) 402-8420

Other practice location 5

2790 Clay Edwards Dr Ste 1235
North Kansas City, MO 64116-3276
Phone (816) 472-5157

Other identifiers 4

IdentifierTypeStateIssuer
010214851MedicaidVA
196654OtherVAANTHEM BCBS
001854467OtherVAMOUNTAIN STATE BCBS
P00349159OtherVARAILROAD MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mfowler752371@direct.ketteringhealth.org
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, FL, NY, NH, AZ, IA, MI, WA, GA, OH, ND, OR, KY, PA, MO15 enrollments
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 15

Enrollment IDStateProvider typePAC IDDetails
I20050729000787 VA Practitioner - Neurology 4688602758 Reassigns benefits to 10 organizations
I20200902002130 FL Practitioner - Neurology 4688602758 Reassigns benefits to 3 organizations
I20201105002191 NY Practitioner - Neurology 4688602758 Reassigns benefits to 5 organizations
I20201113002198 NH Practitioner - Neurology 4688602758 Reassigns benefits to 4 organizations
I20201125002272 AZ Practitioner - Neurology 4688602758 Reassigns benefits to 1 organization
I20201214001329 IA Practitioner - Neuropsychiatry 4688602758
I20201216001677 MI Practitioner - Neurology 4688602758 Reassigns benefits to 1 organization
I20210119002649 WA Practitioner - Neurology 4688602758 Reassigns benefits to 1 organization
I20210203001254 GA Practitioner - Neurology 4688602758 Reassigns benefits to 3 organizations
I20210317002526 OH Practitioner - Neurology 4688602758 Reassigns benefits to 1 organization
I20210816000715 ND Practitioner - Neurology 4688602758 Reassigns benefits to 1 organization
I20210824000308 OR Practitioner - Neurology 4688602758 Reassigns benefits to 2 organizations
I20220909003107 KY Practitioner - Neurology 4688602758 Reassigns benefits to 1 organization
I20230415000160 PA Practitioner - Neurology 4688602758 Reassigns benefits to 1 organization
I20230906001447 MO Practitioner - Neurology 4688602758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Athens Hospitalist Physicians LLCGroup PAC ID 6305196411, 174 clinicians
Altru Health SystemGroup PAC ID 1355251604, 675 clinicians
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians
St. Joseph Hospital of Nashua NHGroup PAC ID 2062455611, 271 clinicians
Piedmont Hospitalist Physicians LLCGroup PAC ID 1951299163, 503 clinicians
Summit Healthcare AssociationGroup PAC ID 3779568647, 78 clinicians
Concord Hospital IncGroup PAC ID 6103721790, 572 clinicians
Meritas Health CorporationGroup PAC ID 6305748153, 492 clinicians
Nchmd IncGroup PAC ID 9436139565, 503 clinicians
St. Joseph HospitalGroup PAC ID 1254222938, 101 clinicians
Virtual Neurology Texas PLLCGroup PAC ID 3779910047, 151 clinicians
Virtual Neurology LLCGroup PAC ID 9830425321, 161 clinicians
Concord Hospital-LaconiaGroup PAC ID 7012326259, 275 clinicians
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 376-3000

1199 Prince Ave
Athens, GA 30606-2797
Phone (706) 475-5076

1200 S Columbia Rd
Grand Forks, ND 58201-4036
Phone (701) 780-5000

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (269) 983-8300

1380 S Columbia Rd
Grand Forks, ND 58201-4059
Phone (701) 795-2000

172 Kinsley St
Nashua, NH 03060-3648
Phone (603) 880-3408

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 605-5000

2200 E Show Low Lake Rd
Show Low, AZ 85901-7831
Phone (928) 537-4375

246 Pleasant St
Concord, NH 03301-2548
Phone (603) 228-7200

2790 Clay Edwards Dr
Suite 1235
North Kansas City, MO 64116-3276
Phone (816) 472-5157

350 7TH St N
Naples Community Hospital
Naples, FL 34102-5754
Phone (239) 436-5100

4295 Hempstead Tpke
Bethpage, NY 11714-5713
Phone (516) 579-6000

50 Route 25a
Smithtown, NY 11787-1348
Phone (631) 862-3000

522 Merrimans LN
Winchester, VA 22601-6208
Phone (239) 208-2212

80 Highland St
Laconia, NH 03246-3235
Phone (603) 527-2819

913 N Dixie Ave
Elizabethtown, KY 42701-2503
Phone (270) 706-5275

9981 S Healthpark Dr
Fort Myers, FL 33908-3618
Phone (239) 343-2606

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20637NHMDNeurology Physician
MD473597PAMDNeurology Physician

Practice roles (60 of 63)

OrganizationSpecialtyStatusNew patients
Winchester Medical Center CurrentSince Oct 10, 2011 Accepting new patients
Meritas Health Corporation Neurology CurrentSince Aug 1, 2023 Accepting new patients
Nchmd, Inc CurrentSince Apr 1, 2023 Accepting new patients
Altru Health System Family Medicine CurrentSince Jul 22, 2021 Accepting new patients
Concord Hospital-Laconia Family Medicine CurrentSince Jun 22, 2022 Accepting new patients
Page Memorial Hospital, Inc. Family Medicine CurrentSince Sep 1, 2008 Accepting new patients
St Joseph Hospital of Nashua NH CurrentSince Nov 17, 2020 Accepting new patients
Silverton Health CurrentSince May 23, 2023 Accepting new patients
Mercy Medical Center CurrentSince Aug 1, 2023 Accepting new patients
Altru Health System CurrentSince Jul 22, 2021 Accepting new patients
Concord Hospital, Inc. CurrentSince Oct 1, 2020 Accepting new patients
Summit Healthcare Association Neurology CurrentSince Jan 1, 2021 Accepting new patients
St. Catherine of Siena Medical Center CurrentSince Sep 1, 2020 Accepting new patients
Concord Hospital, Inc. CurrentSince Oct 1, 2020 Accepting new patients
Lehigh Valley Physician Group Family Medicine CurrentSince Jan 3, 2023 Accepting new patients
Telespecialists North Carolina Neurology Services PLLC Neurology CurrentSince Sep 30, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Oct 1, 2020 Accepting new patients
Page Memorial Hospital, Inc. Current Accepting new patients
Virtual Neurology PC Neurology CurrentSince Mar 30, 2025 Accepting new patients
Legacy Salmon Creek Hospital Hospitalist CurrentSince Feb 1, 2021 Accepting new patients
North Mississippi Medical Center Inc. Neurology CurrentSince May 11, 2024 Accepting new patients
Page Memorial Hospital, Inc. CurrentSince Sep 1, 2008 Accepting new patients
St Joseph Hospital of Nashua NH Family Medicine CurrentSince Nov 17, 2020 Accepting new patients
Lehigh Valley Physician Group Family Medicine Current Accepting new patients
St Charles Hospital Corp CurrentSince Aug 1, 2023 Accepting new patients
Good Samaritan Hospital Medical Center Current Accepting new patients
Lakeland Medical Practices CurrentSince Nov 15, 2020 Accepting new patients
Piedmont Hospitalist Physicians LLC Family Medicine CurrentSince Dec 2, 2020 Accepting new patients
Good Samaritan Hospital Medical CurrentSince Sep 1, 2020 Accepting new patients
Lakeland Medical Practices CurrentSince Nov 15, 2020 Accepting new patients
Piedmont Athens Hospitalist Physicians LLC CurrentSince Jul 7, 2022 Accepting new patients
Mercy Medical Center CurrentSince Aug 1, 2023 Accepting new patients
Kettering Independent Medical Group Inc Family Medicine CurrentSince Oct 21, 2023 Accepting new patients
Meritas Health Corporation Neurology CurrentSince Aug 1, 2023 Accepting new patients
Silverton Health Current Accepting new patients
Winchester Medical Center Current Accepting new patients
Columbus Ambulatory Healthcare Services, Inc. Family Medicine CurrentSince Jul 7, 2022 Accepting new patients
Lee Health System Inc CurrentSince Jan 19, 2025 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Feb 1, 2021 Accepting new patients
Concord Hospital-Franklin Current Accepting new patients
Legacy Clinics LLC CurrentSince May 19, 2021 Accepting new patients
Winchester Medical Center Neurology CurrentSince Oct 10, 2011 Accepting new patients
Summit Healthcare Medical Associates CurrentSince Jan 1, 2021 Accepting new patients
Columbus Ambulatory Healthcare Services, Inc. Family Medicine CurrentSince Jul 7, 2022 Accepting new patients
Meritas Health Corporation Family Medicine Current Accepting new patients
Winchester Neurological Consultants Inc Neurology CurrentSince Jul 15, 2006 Accepting new patients
Nchmd Inc Current Accepting new patients
Silverton Health Family Medicine CurrentSince May 23, 2023 Accepting new patients
Upson Medical Associates LLC Family Medicine CurrentSince Sep 30, 2024 Accepting new patients
St. Joseph Hospital CurrentSince Sep 1, 2020 Accepting new patients
Legacy Clinics LLC Family Medicine CurrentSince May 19, 2021 Accepting new patients
Baptist Health Medical Group Inc Family Medicine CurrentSince Oct 1, 2022 Accepting new patients
Landmark Hospital of Southwest Florida, LLC CurrentSince Apr 1, 2023 Accepting new patients
Lee Health System Inc Family Medicine CurrentSince Jan 19, 2025 Accepting new patients
Virtual Neurology Kansas, LLC Neurology CurrentSince May 19, 2025 Accepting new patients
Lehigh Valley Physician Group Family Medicine CurrentSince Jan 3, 2023 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Oct 1, 2022 Accepting new patients
Lee Memorial Health System Family Medicine CurrentSince Oct 1, 2020 Accepting new patients
University of Virginia Physicians Group PastSince Nov 1, 2017 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations (25 of 63)

2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

11215 Metro Pkwy
Bldg 3
Fort Myers, FL 33966
Phone (470) 816-5071

11215 Metro Pkwy
Ste 1
Fort Myers, FL 33966
Phone (239) 208-2206

11215 Metro Pkwy
Ste 100
Fort Myers, FL 33966
Phone (239) 208-2206

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

9110 College Pointe Ct
Fort Myers, FL 33919
Phone (239) 208-2206

9981 S Healthpark Dr
Fort Myers, FL 33908
Phone (239) 332-5344

11190 Health Park Blvd
Naples, FL 34110
Phone (239) 300-9721

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

680 2nd Ave N
Ste 304
Naples, FL 34102
Phone (239) 261-7711

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

35 Collier Rd NW
Ste 635
Atlanta, GA 30309
Phone (404) 367-3000

1800 10th Ave
Columbus, GA 31901
Phone (706) 571-1120

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

801 W Gordon St
Thomaston, GA 30286
Phone (706) 647-4371

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

9151 NE 81st Ter
Ste 220
Kansas City, MO 64158
Phone (816) 453-4000

9411 N Oak Trfy
Ste LL1
Kansas City, MO 64155
Phone (816) 436-7072

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mfowler124258@soc.inova.org
  • Direct secure messaging: mfowler230504@santaclaravalley.direct-ci.net
  • Direct secure messaging: mfowler4030705@direct.trinity-health.org
  • Direct secure messaging: mfowler573215@direct.emplifyhealth.org
  • Direct secure messaging: mfowler665425@direct.unc.nchie.net
  • Direct secure messaging: mfowler71851@epicdirect.hf.org

Organizations & group practices 66

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 66

Hospital & facility affiliations 8

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1548200116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11215 METRO PKWY BLDG 3",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661206",
            "telephone_number": "239-208-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11215 METRO PKWY STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661206",
            "telephone_number": "239-208-2212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 Eaton Ave",
            "address_purpose": "LOCATION",
            "city": "Hamilton",
            "state": "OH",
            "postal_code": "450132767",
            "country_code": "US",
            "telephone_number": "513-867-2000",
            "fax_number": "513-867-2119",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 26th St S",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "MT",
            "postal_code": "594055161",
            "country_code": "US",
            "telephone_number": "406-731-8888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 Medical Cir",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226013300",
            "country_code": "US",
            "telephone_number": "540-667-1828",
            "fax_number": "540-667-1828",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 S Cedar Crest Blvd Ste 405",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181036224",
            "country_code": "US",
            "telephone_number": "610-402-8420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2790 Clay Edwards Dr Ste 1235",
            "address_purpose": "LOCATION",
            "city": "North Kansas City",
            "state": "MO",
            "postal_code": "641163276",
            "country_code": "US",
            "telephone_number": "816-472-5157",
            "fax_number": "816-472-7201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "MARIECKEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "VA",
            "license": "0101238278",
            "primary": false
        },
        {
            "code": "2084D0003X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Diagnostic Neuroimaging",
            "state": "VA",
            "license": "0101238278",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2020035640",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NH",
            "license": "20637",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD473597",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "S9132",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101238278",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME146337",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME146337",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010214851",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "196654",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNTAIN STATE BCBS",
            "identifier": "001854467",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00349159",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfowler752371@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "630 Eaton Ave",
            "city": "Hamilton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450132767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "630 Eaton Ave",
            "city": "Hamilton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450132767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.