Terry KB Fowler, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

006092 Issued in AZ

Practice address

4745 N 7TH St
Suite 140
Phoenix, AZ 85014-3665

Phone

(602) 735-3761

Fax

(602) 778-3331

NPI assigned

Aug 10, 2005

Last updated

Jan 7, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

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.

• Genesis Medical Clinic

  • Non-Pharmacy Dispensing Site
  • Buena Park, CA
  • NPI 1932436714
  NPD (past)
• Prospect Foothill Urgent Care

  • Urgent Care Clinic/Center
  • Tustin, CA
  • NPI 1366834756
  NPD (past)

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1770584989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3344 S ROCKWELL ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852972148",
            "telephone_number": "480-398-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 N 7TH ST",
            "address_2": "SUITE 140",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850143665",
            "telephone_number": "602-735-3761",
            "fax_number": "602-778-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "TERRY",
        "middle_name": "KB",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A7881",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "006092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA MEDICAL LICENSE",
            "identifier": "006092",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX78810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eva Glenn Fowler, R.PH
• Jennifer Fowler, PSYD
• Karmin Fowler, L.A.C, N.C.C
• Marianne Fowler
• Robert Stuart Fowler, M.D.
• Jordana Fox Kensicki, D.O.
• Debora Fox-McClary, M.D.
• Alexandra Nicole Fox, MD
• Alison L Fox, RDH
• Brandon Michael Fox

• Family Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.