NPIMap

Individual provider Active NPI

Star Viviette Fowler, D.O.

  • Internal Medicine Physician
  • Lakewood, CO
National Provider Identifier
1588891782
Registry record updated Oct 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR.0051309 Issued in CO
Practice address
11750 W 2ND PL
Suite 365
Lakewood, CO 80228-1575
Phone
(720) 321-8280
Fax
(720) 321-8281
NPI assigned
Jun 15, 2009
Last updated
Oct 23, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2015

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 DR.0051309 CO Primary

Addresses

Primary practice location

11750 W 2ND PL
Suite 365
Lakewood, CO 80228-1575

Mailing address

11750 W 2ND PL
Suite 365
Lakewood, CO 80228-1575
Phone (720) 321-8280

Other identifiers 1

IdentifierTypeStateIssuer
22230025MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20120904000253 CO Practitioner - Internal Medicine 7517114143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians

Practice addresses (Care Compare)

255 S Routt St
Lakewood, CO 80228-2354

400 Indiana St
Suite 340
Golden, CO 80401-5033
Phone (720) 452-1267

41 State Hwy 67
Woodland Park, CO 80863-5008
Phone (719) 776-4780

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

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 Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Nov 1, 2015 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Nov 1, 2015 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

11700 W 2nd Pl
Ste 210
Lakewood, CO 80228
Phone (720) 321-8080

11750 W 2nd Pl
Ste 365
Lakewood, CO 80228
Phone (720) 321-8280

1950 Mountain View Ave
Longmont, CO 80501
Phone (303) 651-5000

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 4

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.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445558400000",
    "number": "1588891782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11750 W 2ND PL",
            "address_2": "SUITE 365",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281575",
            "telephone_number": "720-321-8280",
            "fax_number": "720-321-8281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11750 W 2ND PL",
            "address_2": "SUITE 365",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281575",
            "telephone_number": "720-321-8280",
            "fax_number": "720-321-8281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "STAR",
        "middle_name": "VIVIETTE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-15",
        "last_updated": "2015-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0051309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22230025",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.