NPIMap

Individual provider Active NPI

Kenneth Patrick Fowler, M.D.

  • Pediatrics Physician
  • Lawrence, MA
National Provider Identifier
1699849166
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
232594 Issued in MA
Practice address
500 Merrimack St
Lawrence, MA 01843-1756
Phone
(978) 557-8900
Fax
(978) 557-8811
NPI assigned
Nov 17, 2006
Last updated
Nov 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 232594 MA Primary
Internal Medicine Physician 207R00000X 232594 MA

Addresses

Primary practice location

500 Merrimack St
Lawrence, MA 01843-1756

Mailing address

500 Merrimack St
Lawrence, MA 01843-1756
Phone (978) 557-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080104000167 MA Practitioner - Pediatric MedicinePractitioner - Internal Medicine 4183704067 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
Medical University of South Carolina College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 739-6950

1 Park Way
Haverhill, MA 01830-6278
Phone (978) 521-3230

500 Merrimack St
Lawrence, MA 01843-1981
Phone (978) 557-8900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
232594MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Community Physicians Inc CurrentSince Jul 1, 2015 Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc Internal Medicine CurrentSince Jan 1, 2026 Accepting new patients
Mass General Brigham Community Physicians Inc. Internal Medicine CurrentSince Jul 1, 2015 Accepting new patients

Locations

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

66 E Main St
Georgetown, MA 01833
Phone (978) 352-7780

1 Parkway
Haverhill, MA 01830
Phone (978) 521-3210

500 Merrimack St
Lawrence, MA 01843
Phone (978) 557-8800

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

Interoperability endpoints

  • Direct secure messaging: fowler.kenneth.pma@direct.partners.masshiway.net

Organizations & group practices 3

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 9

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1699849166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MERRIMACK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431756",
            "telephone_number": "978-557-8900",
            "fax_number": "978-557-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MERRIMACK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431756",
            "telephone_number": "978-557-8900",
            "fax_number": "978-557-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "KENNETH",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "232594",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "232594",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.