Kirsten Bevan Fowler, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

9794T Issued in TX

Practice address

1101 Melbourne Rd Ste 3091
Hurst, TX 76053-6205

Phone

(817) 284-8686

NPI assigned

Sep 11, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mark J. Page OD PC

  • Optometrist
  • Phoenix, AZ
  • NPI 1629064761
  Medicare reassignment NPD
• Tom Sowash OD & Associates PC

  • Optometrist
  • Chandler, AZ
  • NPI 1174627202
  Medicare reassignment NPD
• Emergency Medical & Surgical Specialists of Colorado LLC

  • Critical Access Hospital
  • Denver, CO
  • NPI 1144669102
  NPD (past)

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1639728603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 PANORAMA CT",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762625602",
            "telephone_number": "817-965-4183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MELBOURNE RD STE 3091",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760536205",
            "telephone_number": "817-284-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "KIRSTEN",
        "middle_name": "BEVAN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9794T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy Leann Floyd, R.PH
• Kayla Fontenot
• Forged in Valor Counseling and Consulting LLC
• Forged Under Fire Counseling & Consulting LLC
• Tanja Minova Foster, M.D.
• Sharon Gail Fowler, FNP
• Alyssa Fox
• Jerry L Franco Jr., PTA
• Randall Glenn Franklin Jr., RMT
• Free for Life Group Corp

• Optometrist in Hurst, TX
• Providers in Hurst, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.