Individual provider Active NPI

Teresa Fowler, DNP

  • Acute Care Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1649942236
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
30267 Issued in TN
Practice address
700 W Forest Ave FL 3
Jackson, TN 38301-3937
Phone
(731) 421-6510
NPI assigned
Oct 1, 2021
Last updated
Apr 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 30267 TN Primary
Family Nurse Practitioner 363LF0000X 30267 TN

Addresses

Primary practice location

700 W Forest Ave FL 3
Jackson, TN 38301-3937

Mailing address

1064 Cuff Rd
Camden, TN 38320-7904
Phone (731) 441-1838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20220210001194 TN Practitioner - Nurse Practitioner 0042603292 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Tennessee Medical Group IncGroup PAC ID 3971781006, 190 clinicians

Practice addresses (Care Compare)

700 W Forest Ave
3Rd Floor
Jackson, TN 38301-3937
Phone (731) 421-6510

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30267TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Center Anesthesia Inc. CurrentSince Nov 6, 2021 Accepting new patients
West Tennessee Medical Group Inc PastSince Apr 1, 2026 Accepting new patients

Locations

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

Organizations & group practices 2

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 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": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1649942236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 CUFF RD",
            "city": "CAMDEN",
            "state": "TN",
            "postal_code": "383207904",
            "telephone_number": "731-441-1838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W FOREST AVE FL 3",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013937",
            "telephone_number": "731-421-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "TERESA",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "30267",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "30267",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.