Organization Active NPI

Fowle Eyecare Associates PLC

  • Optometrist
  • Rockford, MI
National Provider Identifier
1780888081
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002906 Issued in MI
Legal business name
FOWLE EYECARE ASSOCIATES PLC
Practice address
120 Marcell Dr NE
Suite a
Rockford, MI 49341-1362
Phone
(616) 866-0140
Fax
(616) 866-8694
NPI assigned
Jun 12, 2007
Last updated
Sep 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Authorized official

Name
Sharon Scates
Title
Office Manager
Phone
(616) 866-0140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901002906 MI Primary

Addresses

Primary practice location

120 Marcell Dr NE
Suite a
Rockford, MI 49341-1362

Mailing address

120 Marcell Dr NE Ste a
Rockford, MI 49341-1362
Phone (616) 866-0140

Other identifiers 2

IdentifierTypeStateIssuer
5106316MedicaidMI
900D166020OtherMIBCBSM & BLUE CARE NETWORK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201229000820 MI Part B Supplier - Clinic/Group Practice 7012329725 Receives reassigned benefits from 3 practitioners
Practice locations: Rockford, MI

National Provider Directory

National Provider Directory

Locations

120 Marcell Dr NE
Ste A
Rockford, MI 49341
Phone (616) 866-0140

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788393600000",
    "number": "1780888081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MARCELL DR NE STE A",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493411362",
            "telephone_number": "616-866-0140",
            "fax_number": "616-866-8694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MARCELL DR NE",
            "address_2": "SUITE A",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493411362",
            "telephone_number": "616-866-0140",
            "fax_number": "616-866-8694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOWLE EYECARE ASSOCIATES PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A",
        "authorized_official_last_name": "SCATES",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "616-866-0140"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5106316",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM & BLUE CARE NETWORK",
            "identifier": "900D166020",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.