Jerold Todd Fowler, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401007959 Issued in VA

Practice address

2870B S Main St
Harrisonburg, VA 22801-2664

Phone

(540) 434-2423

Fax

(540) 801-0493

NPI assigned

Jan 25, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 19, 2016 through May 19, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760538565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2870B S MAIN ST",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228012664",
            "telephone_number": "540-434-2423",
            "fax_number": "540-801-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2870B S MAIN ST",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228012664",
            "telephone_number": "540-434-2423",
            "fax_number": "540-801-0493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "JEROLD",
        "middle_name": "TODD",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401007959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "394207",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "823297",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA",
            "identifier": "7959",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Clayton Forrest, P.T.
• Hanna Louise Foster
• Kathleen T Foster, COTA/L, ATP
• Fowler Family Medicine, PLLC
• Jeremiah Fowler
• Rocky Wayne Fowler, M.D.
• Tolvert E Fowler Jr., M.D.
• Frederick Louvane Fox, MD
• Jennifer M Fox, CPM
• Mark William Fox, MSN FNP-C

• General Practice Dentistry in Harrisonburg, VA
• Providers in Harrisonburg, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.