Individual provider Active NPI

Taylor Nicole Fowers, PA-C

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Kirkland, WA
National Provider Identifier
1679122758
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
PA61001469 Issued in WA
Practice address
12039 NE 128TH St Ste 400
Kirkland, WA 98034-3029
Phone
(425) 899-4810
NPI assigned
Sep 10, 2019
Last updated
Sep 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X PA61001469 WA Primary

Addresses

Primary practice location

12039 NE 128TH St Ste 400
Kirkland, WA 98034-3029

Mailing address

6484 N Salvia Way
Meridian, ID 83646-4810
Phone (208) 891-1078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20191218002053 WA Practitioner - Physician Assistant 7416381876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12033 NE 130TH LN
Suite 120
Kirkland, WA 98034-3052
Phone (425) 899-2160

12039 NE 128TH St
Kirkland, WA 98034-3029

12040 NE 128TH St
Kirkland, WA 98034-3013

12040 NE 128TH St Ms
Suite 55
Kirkland, WA 98034-3013

1909 214TH St SE
Suite 110
Bothell, WA 98021-4412
Phone (425) 488-4988

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA61001469WAMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 CurrentSince Nov 1, 2019 Accepting new patients
King County Public Hospital District No 2 CurrentSince Nov 1, 2019 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients

Locations

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

12039 NE 128th St
Ste 400
Kirkland, WA 98034
Phone (425) 899-4810

12040 NE 128th St
#50
Kirkland, WA 98034
Phone (425) 899-1894

Organizations & group practices 4

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 3

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": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1679122758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6484 N SALVIA WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836464810",
            "telephone_number": "208-891-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12039 NE 128TH ST STE 400",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343029",
            "telephone_number": "425-899-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWERS",
        "first_name": "TAYLOR",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "WA",
            "license": "PA61001469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.