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

Q: 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.

Q: What is Raphael Fowler's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Raphael Fowler was last updated on December 8, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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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, and ordering and referring status from the CMS PECOS system.

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.

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