Fowler Enterprises Inc
Organization Active NPI Physical Therapist · Moriarty, NM
NPI 1669455994 · NPPES record last updated Feb 9, 2010
Key facts
- NPI
- 1669455994
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1852 (NM)
- Legal business name
- FOWLER ENTERPRISES INC
- Practice address
- 2005B US Route 66 West
Moriarty, NM 87035 - Phone
- (505) 832-4011
- Fax
- (505) 832-0434
- NPI assigned
- Nov 21, 2005
- Organization subpart
- No
Authorized official
- Name
- Mrs. Cheryl Warren Fowler, PT
- Title
- Authorized Representative
- Phone
- (505) 220-6949
Corporate family (same tax ID) 2
Practitioners 20
-
Carolyn G Adie, PHYSICAL THERAPIST
-
Jacob Covell, PT, DPT
-
Jana R. Covell, P.T.
-
Cheryl W Fowler, P.T.
-
Brendan Moore, B.A.
-
Celia R Robinson, OTR/L
-
Roger W. Taft, P.T.
-
Maria L Uriarte, OT
-
Nicholas Matthew Brooker, PT, DPT
-
Cassidy Ann Burgner, PT, DPT
-
Asia Jones, PT, DPT
-
Victor McCutcheon, PT, DPT
-
James Mark Fowler, P.T.
-
Gavin Lynch, PT, DPT
-
Amanda Macewen, OTR/L
-
Ian Christopher Paul, P.T.
-
Lynne Carpenter, PT
-
Paula A Jones-Irvin, P.T.
-
William L Rohrig, THERAPY DIR. II
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041029000133 | NM | Part B Supplier - Clinic/Group Practice | 6305808692 |
Receives reassigned benefits from 16 practitioners Practice locations: Cedar Crest, NM; Moriarty, NM; Edgewood, NM |
National Provider Directory
- Tax ID family
- East Mountain Physical Therapy
Locations
12127 N Highway 14
#B3E
Cedar Crest, NM 87008
Phone (505) 286-3678
12127 Highway 14 N
Ste B3
Cedar Crest, NM 87008
Phone (505) 286-3678
1851 US Highway 66
Ste 2B
Edgewood, NM 87015
8 George Ct
Ste D
Edgewood, NM 87015
3 George Ct
Ste A
Edgewood, NM 87015
Phone (505) 281-8463
141 S 6th St
Santa Rosa, NM 88435
Phone (505) 472-2002
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | 1036 | NM | |
| Physical Therapist |
225100000X | 1037 | NM | |
| Physical Therapist |
225100000X | 1852 | NM | Yes |
Addresses
Primary practice location
2005B US Route 66 West
Moriarty, NM 87035
Mailing address
PO Box 1730
Moriarty, NM 87035-1730
Phone (505) 832-4011
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08028079 | Medicaid | NM |
Other names
- East Mountain Physical Therapy
Other providers in Moriarty, NM
- Tammy Ann Eastham
- Richard Eaton
- Laura E Edimo
- Jeremy Todd Edmonds
- Foundation for Change Integrated Health
- James Mark Fowler
- Ashley Gambling
- Brittney Arlena Gibbons
- Molly Georgianne Hanford
- Terry J Hare
All providers in Moriarty, NM · Physical Therapist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.