MANDI C FOWLER PA-C NPI 1891782900

NPI Information

NPI: 1891782900
Provider Name: MANDI C FOWLER, PA-C
Classification: Physician Assistant - 363AM0700X
Specialization: Medical
Entity Type: Individual
PECOS Registration: Yes
Address: 677 CHURCH ST NE
MARIETTA, GA
ZIP 30060
Phone: (470) 793-6120

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NPI Details

Mandi C Fowler, PA-C is a medical physician assistant in Marietta, GA. Mandi C Fowler, PA-C NPI is 1891782900. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

677 CHURCH ST NE
MARIETTA, GA
ZIP 30060-101
Phone: (470) 793-6120
Fax: (770) 999-2647

The NPI 1891782900 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus (HCPCS:87426)

The enumeration date for this NPI number is 10/4/2005 and was last updated on 11/14/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	3873	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	875872035B	MEDICAID	GEORGIA
2	875872035F	MEDICAID	GEORGIA
3	647119263A	MEDICAID	GEORGIA
4	875872035C	MEDICAID	GEORGIA
5	875872035E	MEDICAID	GEORGIA
6	875872035D	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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