Individual provider Active NPI

Emma Cotton Fowler, PA-C

  • Surgical Physician Assistant
  • Memphis, TN
National Provider Identifier
1578197919
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4066 Issued in TN
Practice address
6286 Briarcrest Ave Ste 200
Memphis, TN 38120-4023
Phone
(901) 641-3000
Fax
(901) 259-1698
NPI assigned
Feb 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 4066 TN Primary
Medical Physician Assistant 363AM0700X 4066 TN

Addresses

Primary practice location

6286 Briarcrest Ave Ste 200
Memphis, TN 38120-4023

Mailing address

6077 Primacy Pkwy Ste 140
Memphis, TN 38119-5754
Phone (901) 725-8347

Other practice location 1

7580 Clarington Cv
Southaven, MS 38671-5657
Phone (901) 641-3000

Other practice location 2

2100 Exeter Rd Ste 200
Germantown, TN 38138-3966
Phone (901) 641-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200406002403 TN Practitioner - Physician Assistant 4981033354 Reassigns benefits to 1 organization
I20200508000887 MS Practitioner - Physician Assistant 4981033354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Tennessee, HSC, College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6077 Primacy Pkwy
Suite 140
Memphis, TN 38119

6077 Primacy Pkwy
Suite 140
Memphis, TN 38119-5754

6077 Primary Pkwy
Ste. 140
Memphis, TN 38119-5742

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4066TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Group, PC Surgical CurrentSince Mar 1, 2020 Accepting new patients
MSK Group, PC CurrentSince Mar 1, 2020 Accepting new patients
MSK Group PC CurrentSince May 1, 2020 Accepting new patients

Locations

2670 McIngvale Rd
Ste J
Hernando, MS 38632
Phone (662) 548-2710

7580 Clarington Cv
Southaven, MS 38671
Phone (901) 259-1600

2100 Exeter Rd
Ste 200
Germantown, TN 38138
Phone (901) 522-6440

6286 Briarcrest Ave
Ste 200
Memphis, TN 38120
Phone (901) 259-1600

6286 Briarcrest Ave
#200
Memphis, TN 38120
Phone (901) 259-1600

6077 E Primacy Pkwy
Ste 140
Memphis, TN 38119
Phone (901) 725-8347

6286 Briarcrest Ave
Ste 100
Memphis, TN 38120
Phone (901) 259-1600

6286 Briarcrest Ave
Memphis, TN 38120
Phone (901) 259-1600

Interoperability endpoints

  • Direct secure messaging: efowler25655@mlh.direct-ci.com

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 1

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": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1578197919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6077 PRIMACY PKWY STE 140",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195754",
            "telephone_number": "901-725-8347",
            "fax_number": "901-259-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6286 BRIARCREST AVE STE 200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381204023",
            "telephone_number": "901-641-3000",
            "fax_number": "901-259-1698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7580 Clarington Cv",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386715657",
            "country_code": "US",
            "telephone_number": "901-641-3000",
            "fax_number": "901-259-7637",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Exeter Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383966",
            "country_code": "US",
            "telephone_number": "901-641-3000",
            "fax_number": "901-373-3804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "EMMA",
        "middle_name": "COTTON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-25",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "4066",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "4066",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.