Individual provider Active NPI

Andrea Fowler, L.AC

  • Acupuncturist
  • Minneapolis, MN
National Provider Identifier
1578801833
Registry record updated Jan 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
1638 Issued in MN
Practice address
3541 Lyndale Ave S
Minneapolis, MN 55408-4159
Phone
(612) 824-1829
NPI assigned
Jan 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 1638 MN Primary

Addresses

Primary practice location

3541 Lyndale Ave S
Minneapolis, MN 55408-4159

Mailing address

5021 Vernon Ave S
Suite 257
Edina, MN 55436-2102
Phone (952) 220-0113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1638MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pivotal Edge, LLC Current Accepting new patients
Lucky Cat Acupuncture and Herbal Medicine Acupuncturist Past Accepting new patients
Dr Moses S M Smith Chiropractic LLC PastSince Mar 1, 2014 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1358812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358812800000",
    "number": "1578801833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5021 VERNON AVE S",
            "address_2": "SUITE 257",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554362102",
            "telephone_number": "952-220-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3541 LYNDALE AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084159",
            "telephone_number": "612-824-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "L.AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-22",
        "last_updated": "2013-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "1638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.