NPIMap

Individual provider Active NPI

Elizabeth Rose Fowlkes, P.A.

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1871811729
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002181 Issued in IA
Practice address
987400 Nebraska Medical Ctr
Omaha, NE 68198-7400
Phone
(402) 559-6673
Fax
(402) 559-8333
NPI assigned
May 16, 2010
Last updated
Jun 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 002181 IA Primary
Medical Physician Assistant 363AM0700X 1501 NE

Addresses

Primary practice location

987400 Nebraska Medical Ctr
Omaha, NE 68198-7400

Mailing address

988102 Nebraska Medical Ctr
Omaha, NE 68198-8102
Phone (402) 559-6673

Other identifiers 1

IdentifierTypeStateIssuer
1871811729OtherIAWELLMARK BCBS OF IA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, NE2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110329000344 IA Practitioner - Physician Assistant 4880728799 Reassigns benefits to 4 organizations
I20110511000691 NE Practitioner - Physician Assistant 4880728799 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1501NEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cass County Memorial Hospital CurrentSince Mar 15, 2021 Accepting new patients
New Century Physicians of Nebraska LLC CurrentSince Dec 30, 2018 Accepting new patients
Cass County Memorial Hospital Current Accepting new patients
Alegent Creighton Clinic Physician Assistant CurrentSince Aug 31, 2023 Accepting new patients
Pgfhgs Holdings LLC CurrentSince Oct 23, 2025 Accepting new patients
Cass County Memorial Hospital CurrentSince Mar 15, 2021 Accepting new patients
Cass County Memorial Hospital Current Accepting new patients

Locations

1501 E 10th St
Atlantic, IA 50022
Phone (712) 243-2850

800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500

11111 S 84th St
Papillion, NE 68046
Phone (402) 593-3000

Interoperability endpoints

  • Direct secure messaging: efowlkes200697@uihcdirect.org
  • Direct secure messaging: elizabeth.fowlkes.1@31007.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1273968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1871811729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102",
            "telephone_number": "402-559-6673",
            "fax_number": "402-559-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "987400 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681987400",
            "telephone_number": "402-559-6673",
            "fax_number": "402-559-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLKES",
        "first_name": "ELIZABETH",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-16",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "002181",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1501",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS OF IA",
            "identifier": "1871811729",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.