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RAPHAEL B FOWLER AGPCNP-C
NPI 1093519837
Nurse Practitioner - Adult Health in Stone Mountain, GA

Active since April 02, 2025PECOS Enrolled
4958 MEMORIAL DR, STONE MOUNTAIN, GA 30083(678) 542-9756 Get Directions Write a Review

NPPES record last updated: December 8, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 8, 2025, Apr 2, 2025 (2 updates tracked since 2025).

About Raphael B Fowler Agpcnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RAPHAEL B FOWLER AGPCNP-C (NPI 1093519837) is an individual adult health provider in Stone Mountain, Georgia, licensed in Georgia (RN276645) and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1093519837
Entity TypeIndividualMale
Primary Taxonomy363LA2200X
Provider Legal NameRAPHAEL B FOWLERCredential: AGPCNP-C
Location Address4958 MEMORIAL DRStone Mountain, GA 30083-4148
Mailing Address3387 Peachtree Corners Cir Apt IPeachtree Corners, GA 30092-4351 · (678) 542-9756
Phone(678) 542-9756
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateApril 2, 2025
Last NPPES UpdateDecember 8, 20252 updates tracked since enumeration
NPPES CertifiedDecember 8, 2025
✔ NPI 1093519837 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in GA · RN276645
4958 MEMORIAL DR, Stone Mountain, GA 30083
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Raphael B Fowler Agpcnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1850885658
PECOS Enrollment IDI20251209004101
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Raphael Fowler reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Community Care Health Network LLC
218 mi
Nurse Practitioner
424 CHURCH ST STE 220
Nashville, TN 37219
  • Reassigned Medicare billing, Georgia enrollment
  • 274 clinicians in this Medicare group
NPI 1619368842 (877) 564-3627

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30083 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEMORIAL DRIVE FAMILY MEDICINE P.C
Family Medicine
4958 MEMORIAL DR
STONE MOUNTAIN, GA 30083
Dekalb County (404) 809-2480
MARSHET TENAW
Nurse Practitioner (Family)
4958 MEMORIAL DR
STONE MOUNTAIN, GA 30083
Dekalb County (404) 809-2480
DR. TASSEW TESFAYE M.D.
Family Medicine
4958 MEMORIAL DR
STONE MOUNTAIN, GA 30083
Dekalb County (404) 809-2480
HOPE DISPENSARY
Non-Pharmacy Dispensing Site
4958 MEMORIAL DR
STONE MOUNTAIN, GA 30083
Dekalb County (404) 809-2486
SELAMAWIT WEHABE TSEGA MDCE
Physician Assistant
4958 MEMORIAL DR
STONE MOUNTAIN, GA 30083
Dekalb County (404) 809-2480

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Raphael Fowler's NPI number?

The NPI number for Raphael Fowler is 1093519837. It was assigned to this individual provider in the NPPES registry on April 2, 2025.

Where is Raphael Fowler located?

Raphael Fowler practices at 4958 Memorial Dr, Stone Mountain, GA 30083. The listed phone number is (678) 542-9756.

What is Raphael Fowler's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Raphael Fowler enrolled in Medicare?

Yes. Raphael Fowler is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Raphael Fowler's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Raphael Fowler reassigns Medicare benefits to Community Care Health Network LLC (Nashville, TN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Raphael Fowler's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Raphael Fowler was last updated on December 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.