Evan Fowle, D.O.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

6290 Issued in OK

Practice address

225 NE 97TH St Ste 600
Oklahoma City, OK 73114-6302

Phone

(405) 842-2061

NPI assigned

Apr 30, 2012

Last updated

Aug 11, 2022By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Pathology

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Diagnostic Pathology Services, Inc.Group PAC ID 8224941547, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028
• Integris Canadian Valley Hospital Hospital, Yukon, OK, CCN 370211
• Integris Health Edmond Hospital Hospital, Edmond, OK, CCN 370236

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Diagnostic Pathology Services, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Oklahoma City, OK
  • NPI 1528030897
  Medicare reassignment Care Compare group NPD
• Choctaw Nation of Oklahoma

  dba Choctaw Nation Health Clinic-Broken Bow

  • Primary Care Clinic/Center
  • Broken Bow, OK
  • NPI 1770559619
  NPD (past)
• Diagnostic Pathology Services, Inc.

  • Clinical Medical Laboratory
  • Oklahoma City, OK
  • NPI 1851363253
  NPD (past)

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

• Integris Baptist Medical Center Inc

  dba INTEGRIS Decisions Mental Health and Addiction Recovery Programs

  • Psychiatric Hospital Unit
  • Oklahoma City, OK
  • NPI 1598837221
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  dba Integris Mental Health Center

  • Psychiatric Hospital Unit
  • Spencer, OK
  • NPI 1659443372
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  dba Integris Health Baptist Medical Center

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1831103654
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  dba Integris Mental Health Center Acute

  • Psychiatric Hospital Unit
  • Spencer, OK
  • NPI 1881760759
  Care Compare affiliation
• Integris Canadian Valley Hospital

  • General Acute Care Hospital
  • Yukon, OK
  • NPI 1306865357
  Care Compare affiliation
• Integris Health Edmond, Inc

  dba INTEGRIS Health Edmond Hospital

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1720373103
  Care Compare affiliation

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1649538505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD STE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013614",
            "fax_number": "610-271-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 NE 97TH ST STE 600",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731146302",
            "telephone_number": "405-842-2061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 10th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100191147",
            "country_code": "US",
            "telephone_number": "212-523-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "940 Stanton L Young Blvd # 451",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731045020",
            "country_code": "US",
            "telephone_number": "405-271-2422",
            "fax_number": "400-527-1256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 10th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100191147",
            "country_code": "US",
            "telephone_number": "212-523-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLE",
        "first_name": "EVAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-30",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OK",
            "license": "6290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Four Seasons Nursing Centers Inc (Manor Care Health Services - Northwest)
• Nathaniel Richard Fout, PH.D., M.D.
• Tammy Lynn Fowler Rice, LCSW
• Bonnie Dee Fowler, LPC
• Dayelon Fowler
• Joel Douglas Fowler
• Joey Fowler, MD

• Anatomic Pathology & Clinical Pathology Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Anatomic Pathology & Clinical Pathology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.