Individual provider Active NPI

Scott J. Fowler, D.O.

  • Family Medicine Physician
  • Broken Arrow, OK
National Provider Identifier
1952563892
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4635 Issued in OK
Practice address
1130 E Lansing St
Broken Arrow, OK 74012-2429
Phone
(918) 258-9990
Fax
(918) 251-9399
NPI assigned
Jul 1, 2008
Last updated
Dec 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4635 OK Primary

Addresses

Primary practice location

1130 E Lansing St
Broken Arrow, OK 74012-2429

Mailing address

1130 E Lansing St
Broken Arrow, OK 74012-2429
Phone (918) 258-9990

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090311000646 OK Practitioner - Family Practice 6709942063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2440 E 81St St
Tulsa, OK 74137-4200
Phone (918) 477-5190

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4635OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Oklahoma Physician Network Inc Family Medicine Current Accepting new patients
Northeast Oklahoma Physician Network Inc CurrentSince Dec 1, 2019 Accepting new patients
Urgent Care Incorporated Family Medicine Past Accepting new patients

Locations

1130 E Lansing St
Broken Arrow, OK 74012
Phone (918) 258-9111

1130 E Lansing St
Ste A
Broken Arrow, OK 74012
Phone (918) 258-9990

2440 E 81st St
Tulsa, OK 74137
Phone (918) 392-8856

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIHBDD

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1952563892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 E LANSING ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122429",
            "telephone_number": "918-258-9990",
            "fax_number": "918-251-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 E LANSING ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122429",
            "telephone_number": "918-258-9990",
            "fax_number": "918-251-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "SCOTT",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-01",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "4635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

Verify at the official NPI Registry.