Melissa Ann Fowler, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-100415 Issued in ID

Practice address

413 SW 5TH Ave Ste 100
Meridian, ID 83642-8601

Phone

(208) 370-2020

NPI assigned

Aug 27, 2007

Last updated

Jun 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Melissa Ann McKaig Former name

Medicare fee-for-service enrollment

Enrolled in ID

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.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eyes on Meridian LLCGroup PAC ID 4587073788, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eyes on Meridian LLC

  • Optometrist
  • Meridian, ID
  • NPI 1538792551
  Medicare reassignment Care Compare group NPD
• Eyecare Specialties of Idaho PC

  • Optometrist
  • Preston, ID
  • NPI 1417848037
  NPD (past)

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1770776353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 SW 5TH AVE STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428601",
            "telephone_number": "208-370-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 SW 5TH AVE STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428601",
            "telephone_number": "208-370-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-27",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13329 T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "MCKAIG",
            "middle_name": "ANN",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Colleen Foster, CADC
• Shayla Diane Foster, MS, LAT, ATC
• Eric Fountain
• Brandon Boekamp Fowler, D.D.S.
• John Michael Fowler, MD
• Molly Dee Fowler
• Elli Fox, PA
• John Stephen Fox, M.D,
• Navy Ann Fox
• Joan Fraino, NP

• Optometrist in Meridian, ID
• Providers in Meridian, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.