Individual provider Active NPI

Lisa Wilcox Fowler, RPH

Pharmacist
Fairfax, VA

National Provider Identifier

1811355688

Registry record updated Nov 6, 2023

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Organizations & group practices1
NPI Registry JSON
Other providers in Fairfax, VA
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: PharmacistTaxonomy code 183500000X
License: 0202220418 Issued in VA
Practice address: 3545 Chain Bridge Rd Ste 102
Fairfax, VA 22030-2708
Phone: (571) 732-4633
Fax: (571) 732-4643
NPI assigned: Feb 8, 2016
Sex: Female
Sole proprietor: Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 15

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	03331630	OH
Pharmacist	183500000X	057706	NY
Pharmacist	183500000X	08982	MS
Pharmacist	183500000X	19233	AL
Pharmacist	183500000X	S021905	AZ
Pharmacist	183500000X	1-117754	KS
Pharmacist	183500000X	022865	KY
Pharmacist	183500000X	PST.021598	LA
Pharmacist	183500000X	24188	MD
Pharmacist	183500000X	PH236963	MA
Pharmacist	183500000X	5302414520	MI
Pharmacist	183500000X	17573	NE
Pharmacist	183500000X	22963	NV
Pharmacist	183500000X	R-19700	OK
Pharmacist	183500000X	0202220418	VA	Primary

Addresses

Primary practice location

3545 Chain Bridge Rd Ste 102
Fairfax, VA 22030-2708

Mailing address

3545 Chain Bridge Rd Ste 102
Fairfax, VA 22030-2708
Phone (571) 732-4633

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Not enrolled
Credentials: Registered Pharmacist

State licenses

License	State	Type	Specialty
19233	AL	MD	Pharmacist
S021905	AZ	MD	Pharmacist
1-117754	KS	MD	Pharmacist
022865	KY	MD	Pharmacist
PST.021598	LA	MD	Pharmacist
PH236963	MA	MD	Pharmacist
24188	MD	MD	Pharmacist
5302414520	MI	MD	Pharmacist
08982	MS	MD	Pharmacist
17573	NE	MD	Pharmacist
22963	NV	MD	Pharmacist
057706	NY	MD	Pharmacist
03331630	OH	MD	Pharmacist
R-19700	OK	MD	Pharmacist
0202220418	VA	MD	Pharmacist

Practice roles

Organization	Specialty	Status	New patients
Beauty Empower RX LLC	Pharmacist	PastSince Nov 12, 2023	Accepting new patients

Organizations & group practices 1

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.

Beauty Empower RX LLC
- Pharmacist
- Fairfax, VA
- NPI 1487118451
NPD (past)

NPI Registry JSON

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1811355688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 CHAIN BRIDGE RD STE 102",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302708",
            "telephone_number": "571-732-4633",
            "fax_number": "571-732-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 CHAIN BRIDGE RD STE 102",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302708",
            "telephone_number": "571-732-4633",
            "fax_number": "571-732-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "LISA",
        "middle_name": "WILCOX",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-08",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03331630",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "057706",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "08982",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "19233",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S021905",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-117754",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "022865",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PST.021598",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "24188",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH236963",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302414520",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "17573",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "22963",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "R-19700",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202220418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.