Individual provider Active NPI

Jeffrey M. Fowler, M.D.

  • Gynecologic Oncology Physician
  • Hilliard, OH
National Provider Identifier
1639112451
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
35056039 Issued in OH
Practice address
3651 Ridge Mill Dr
Hilliard, OH 43026-7752
Phone
(614) 293-3873
Fax
(614) 293-3078
NPI assigned
Jun 13, 2006
Last updated
Dec 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 01086901A IN
Gynecologic Oncology Physician 207VX0201X 35056039 OH Primary

Addresses

Primary practice location

3651 Ridge Mill Dr
Hilliard, OH 43026-7752

Mailing address

3651 Ridge Mill Dr
Hilliard, OH 43026-7752
Phone (614) 293-3873

Other practice location 1

4055 Gateway Blvd
Newburgh, IN 47630-7451
Phone (812) 842-2210

Other identifiers 2

IdentifierTypeStateIssuer
0677816MedicaidOH
300057437MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20211206000922 IN Practitioner - Gynecological Oncology 6305744517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological Oncology
Education
Northwestern University Feinberg Medical School, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4199 Gateway Blvd
Newburgh, IN 47630-8940
Phone (812) 842-4200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35056039OHMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Women's Hospital of Southern Indiana, LLC Gynecologic Oncology CurrentSince Dec 31, 2021 Accepting new patients
Deaconess Women's Hospital of Southern Indiana, LLC Gynecologic Oncology Current Accepting new patients
Deaconess Women's Hospital of Southern Indiana, LLC CurrentSince Dec 31, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

4055 Gateway Blvd
Newburgh, IN 47630
Phone (812) 842-2210

4199 Gateway Blvd
Newburgh, IN 47630
Phone (812) 842-4200

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 3

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1639112451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3651 RIDGE MILL DR",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430267752",
            "telephone_number": "614-293-3873",
            "fax_number": "614-266-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 RIDGE MILL DR",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430267752",
            "telephone_number": "614-293-3873",
            "fax_number": "614-293-3078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4055 Gateway Blvd",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "IN",
            "postal_code": "476307451",
            "country_code": "US",
            "telephone_number": "812-842-2210",
            "fax_number": "812-842-4599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "JEFFREY",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "IN",
            "license": "01086901A",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "OH",
            "license": "35056039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0677816",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300057437",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilliard, OH

Sources for this page

Verify at the official NPI Registry.