Tammy S Fowler, FNP

Individual provider Active NPI Family Nurse Practitioner · Sikeston, MO

NPI 1811086291 · NPPES record last updated Apr 1, 2014

Key facts

NPI
1811086291
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
086351 (MO)
Practice address
1008 N Main St
Sikeston, MO 63801-5044
Phone
(573) 472-6001
Fax
(573) 472-6006
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Health Center of Stoddard County LLC (39 clinicians)

Practice addresses (Care Compare)

1003
25 Southeast Health Center of Stoddard
Bloomfield, MO 63825
Phone (573) 568-3686

Hospital & facility affiliations

  • Mercy Hospital Stoddard Hospital · Dexter, MO · CCN 260160
  • Mercy Hospital Southeast Hospital · Cape Girardeau, MO · CCN 260110

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20050328000015 MO Practitioner - Nurse Practitioner 0840246419 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Health Center of Stoddard County, LLC Current
since Nov 1, 2021
Accepting new patients
Southeast Health Center of Stoddard County LLC Current
since Nov 1, 2021
Accepting new patients
Southeast Health Center of Stoddard County, LLC Current Accepting new patients

Locations

1200 N One Mile Rd
Dexter, MO 63841
Phone (573) 614-1900

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 086351 MO Yes

Addresses

Primary practice location

1008 N Main St
Sikeston, MO 63801-5044

Mailing address

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 472-6001

Other providers in Sikeston, MO

All providers in Sikeston, MO · Family Nurse Practitioner in Missouri

Sources for this page

Verify at the official NPI Registry.