Individual provider Active NPI

Melanie Cottier Fowler, NP

  • Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1912128786
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP-03354 Issued in NM
Practice address
4710 Jefferson St NE
Albuquerque, NM 87109-2155
Phone
(505) 955-9454
Fax
(505) 888-9644
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP103778 TX
Nurse Practitioner 363L00000X CNP-03354 NM Primary

Addresses

Primary practice location

4710 Jefferson St NE
Albuquerque, NM 87109-2155

Mailing address

PO Box 6880
Santa Fe, NM 87502-6880
Phone (505) 216-0332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171201000687 NM Practitioner - Nurse Practitioner 6305946567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Care CenterGroup PAC ID 8921043035, 28 clinicians

Practice addresses (Care Compare)

4710 Jefferson NE
Suite a
Albuquerque, NM 87109-2156
Phone (505) 955-9454

649 Harkle Rd
Suite E
Santa Fe, NM 87505-4765
Phone (505) 955-9454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP-03354NMMDNurse Practitioner
AP103778TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Care Center CurrentSince Oct 11, 2022 Accepting new patients
Southwest Care Center CurrentSince Oct 11, 2022 Accepting new patients

Locations

4710 Jefferson St NE
Ste A
Albuquerque, NM 87109
Phone (505) 780-4044

4710 Jefferson St NE
Albuquerque, NM 87109
Phone (505) 883-1259

649 Harkle Rd
Ste E
Santa Fe, NM 87505
Phone (505) 955-9454

Interoperability endpoints

  • Direct secure messaging: melanie.fowler.1@19212.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1912128786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6880",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875026880",
            "telephone_number": "505-216-0332",
            "fax_number": "505-982-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 JEFFERSON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092155",
            "telephone_number": "505-955-9454",
            "fax_number": "505-888-9644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "MELANIE",
        "middle_name": "COTTIER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP103778",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "CNP-03354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.