Individual provider Active NPI

Moayad Shafiq Rashanne Fowler, NNP-BC

  • Nurse Practitioner
  • Wilmington, DE
National Provider Identifier
1942829643
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
LM-0000177 Issued in DE
Practice address
1600 Rockland Rd
Wilmington, DE 19803-3607
Phone
(302) 651-4000
NPI assigned
Apr 13, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X LM-0000177 DE
Nurse Practitioner 363L00000X LM-0000177 DE Primary

Addresses

Primary practice location

1600 Rockland Rd
Wilmington, DE 19803-3607

Mailing address

PO Box 191
Rockland, DE 19732-0191
Phone (302) 651-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241004003699 MD Practitioner - Nurse Practitioner 1557892254 Reassigns benefits to 1 organization
I20250722000381 DE Practitioner - Nurse Practitioner 1557892254 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LM-0000177DEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Sep 1, 2024 Accepting new patients
Bayhealth Medical Center, Inc. CurrentSince May 1, 2025 Accepting new patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Sep 1, 2024 Accepting new patients
Bayhealth Medical Center, Inc. CurrentSince May 1, 2025 Accepting new patients
Bayhealth Medical Center, Inc CurrentSince May 1, 2025 Accepting new patients

Locations

640 S State St
Dover, DE 19901
Phone (302) 744-4700

100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

7601 Osler Dr
Towson, MD 21204
Phone (410) 337-1150

Interoperability endpoints

  • Direct secure messaging: mfowler82204@direct.nemours.org
  • Direct secure messaging: mfowler1176332@direct.umm.edu

Organizations & group practices 5

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": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1942829643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-4200",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033607",
            "telephone_number": "302-651-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "MOAYAD",
        "middle_name": "SHAFIQ RASHANNE",
        "name_prefix": "Mr.",
        "credential": "NNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-13",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "DE",
            "license": "LM-0000177",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LM-0000177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.