NPIMap

Organization Active NPI

Fowler Enterprises, Inc.

Doing business as East Mountain Physical Therapy

  • Physical Therapist
  • Edgewood, NM
National Provider Identifier
1821270828
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
FOWLER ENTERPRISES, INC.
Doing business as
East Mountain Physical Therapy
Practice address
1851-2B Old Highway 66
Edgewood, NM 87015
Phone
(505) 281-8463
NPI assigned
Nov 30, 2007
Last updated
Dec 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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

Authorized official

Name
Cheryl W Fowler, PT
Title
Owner/ Authorized Representative
Phone
(505) 220-6949

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

1851-2B Old Highway 66
Edgewood, NM 87015

Mailing address

PO Box 1730
Moriarty, NM 87035-1730
Phone (505) 281-8463

Other identifiers 1

IdentifierTypeStateIssuer
08028079MedicaidNM

Other names 1

  • East Mountain Physical Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
East Mountain Physical Therapy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324512000000",
    "number": "1821270828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1730",
            "city": "MORIARTY",
            "state": "NM",
            "postal_code": "870351730",
            "telephone_number": "505-281-8463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851-2B OLD HIGHWAY 66",
            "city": "EDGEWOOD",
            "state": "NM",
            "postal_code": "87015",
            "telephone_number": "505-281-8463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOWLER ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2011-12-22",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/ AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "505-220-6949",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08028079",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Mountain Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edgewood, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; 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.