Individual provider Active NPI

Lane Andrew Fowler, MD

  • Neurology Physician
  • Canton, GA
National Provider Identifier
1699129288
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
00000 Issued in GA
Practice address
450 Northside Cherokee Blvd
Canton, GA 30115-8015
Phone
(770) 224-1000
Fax
(770) 224-2451
NPI assigned
Apr 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neurology Physician 2084N0400X 00000 GA Primary

Addresses

Primary practice location

450 Northside Cherokee Blvd
Canton, GA 30115-8015

Mailing address

128 E Apple St
2ND Floor
Dayton, OH 45409-2902
Phone (937) 208-2004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20200826001556 GA Practitioner - Neurology 3678865870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Professional Services LLCGroup PAC ID 0840291944, 423 clinicians

Practice addresses (Care Compare)

450 Northside Cherokee Blvd
Canton, GA 30115-8015
Phone (770) 224-1000

Hospital & facility affiliations

  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008

Merit-based Incentive Payment System (MIPS)

Final score
98.79 of 100Reported as group
Quality
98.74
Improvement activities
40
Cost
83.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00000GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
North Atlanta Professional Services LLC CurrentSince Aug 18, 2020 Accepting new patients

Locations

450 Northside Cherokee Blvd
Canton, GA 30115
Phone (770) 224-1000

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1699129288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 E APPLE ST",
            "address_2": "2ND FLOOR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092902",
            "telephone_number": "937-208-2004",
            "fax_number": "937-208-8828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 NORTHSIDE CHEROKEE BLVD",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158015",
            "telephone_number": "770-224-1000",
            "fax_number": "770-224-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "LANE",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-20",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "00000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.