Individual provider Active NPI

Cory Fowler, PA

  • Physician Assistant
  • Pensacola, FL
National Provider Identifier
1629520333
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109910 Issued in FL
Practice address
4551-A North Davis Hwy
Pensacola, FL 32503-2782
Phone
(850) 494-9001
NPI assigned
Oct 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9109910 FL Primary

Addresses

Primary practice location

4551-A North Davis Hwy
Pensacola, FL 32503-2782

Mailing address

PO Box 2699
Pensacola, FL 32513-2699
Phone (850) 494-9001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161122000230 FL Practitioner - Physician Assistant 8527347137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

1890 Summit Blvd
Pensacola, FL 32503-3357
Phone (850) 416-7000

4501 N Davis Hwy
Suite a
Pensacola, FL 32504-2724
Phone (850) 476-9000

5151 N 9TH Ave
Suite 200
Pensacola, FL 32504-8721
Phone (850) 416-4188

Hospital & facility affiliations

  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9109910FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System Inc CurrentSince Nov 1, 2016 Accepting new patients
Sacred Heart Health System, Inc. CurrentSince Nov 1, 2016 Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients

Locations

1890 Summit Blvd
Ste 240
Pensacola, FL 32503
Phone (850) 746-0600

4501 N Davis Hwy
Ste A
Pensacola, FL 32503
Phone (850) 476-9000

Interoperability endpoints

  • Direct secure messaging: cory.fowler.1@9582.direct.athenahealth.com

Organizations & group practices 5

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": "1477612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1629520333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-494-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4551-A NORTH DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032782",
            "telephone_number": "850-494-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "CORY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-28",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.