James Mark Fowler, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1036 Issued in NM

Practice address

2005 W US Route 66
Suite C
Moriarty, NM 87035

Phone

(505) 832-4011

Fax

(505) 832-0434

NPI assigned

Nov 17, 2006

Last updated

Jan 31, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fowler Enterprises Inc

  dba East Mountain Physical Therapy

  • Physical Therapist
  • Moriarty, NM
  • NPI 1669455994
  Medicare reassignment NPD

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1649344276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1730",
            "city": "MORIARTY",
            "state": "NM",
            "postal_code": "870351730",
            "telephone_number": "505-832-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 W US ROUTE 66",
            "address_2": "SUITE C",
            "city": "MORIARTY",
            "state": "NM",
            "postal_code": "87035",
            "telephone_number": "505-832-4011",
            "fax_number": "505-832-0434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "JAMES",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "1036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H1865",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Eaton, M.S.
• Laura E Edimo, LMSW
• Jeremy Todd Edmonds, D.O.
• Foundation for Change Integrated Health
• Fowler Enterprises Inc (East Mountain Physical Therapy)
• Ashley Gambling, FNP-C
• Brittney Arlena Gibbons
• Molly Georgianne Hanford, MS TSSLD
• Terry J Hare, LMT
• Healing Word LLC

• Physical Therapist in Moriarty, NM
• Providers in Moriarty, NM by specialty
• Physical Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.