CORY FOWLER MSN, A.P.R.N., FNP-C
NPI 1154807196
Nurse Practitioner - Family in Provo, UT

Active since July 12, 2018Opted out of Medicare · through Jan 29, 2028
3650 N UNIVERSITY AVE STE 200, PROVO, UT 84604(801) 375-7102(801) 375-7102 Get Directions Write a Review

NPPES record last updated: July 12, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Cory Fowler Msn, A.p.r.n., Fnp-c NPPES

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

CORY FOWLER MSN, A.P.R.N., FNP-C (NPI 1154807196) is an individual family provider in Provo, Utah, licensed in Utah (7867102-4405) and active in the NPI registry since July 2018. He has opted out of Medicare through January 29, 2028.

NPPES Registry Identity

NPI1154807196
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameCORY FOWLERCredential: MSN, A.P.R.N., FNP-C
Location Address3650 N UNIVERSITY AVE STE 200Provo, UT 84604-6658
Mailing Address3650 N University Ave Ste 200Provo, UT 84604-6658 · (801) 375-7102 · Fax (801) 375-7102
Fax(801) 375-7102
Sole ProprietorNo
Enumeration DateJuly 12, 2018
NPI 1154807196 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in UT · 7867102-4405
3650 N UNIVERSITY AVE STE 200, Provo, UT 84604

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Cory Fowler Msn, A.p.r.n., Fnp-c has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 29, 2020 through January 29, 2028.

Opt-Out Effective DateJanuary 29, 2020
Opt-Out In Effect ThroughJanuary 29, 2028Opt-out affidavits renew automatically every two years unless cancelled

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.

Integrative Medicine
3650 N UNIVERSITY AVE STE 200
PROVO, UT 84604
Family Medicine
3650 N UNIVERSITY AVE STE 200
PROVO, UT 84604
Nurse Practitioner (Family)
3650 N UNIVERSITY AVE STE 200
PROVO, UT 84604
Plastic Surgery
3650 N UNIVERSITY AVE STE 200
PROVO, UT 84604
Nurse Practitioner (Family)
3650 N UNIVERSITY AVE STE 200
PROVO, UT 84604

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 Cory Fowler's NPI number?

The NPI number for Cory Fowler is 1154807196. It was assigned to this individual provider in the NPPES registry on July 12, 2018.

Where is Cory Fowler located?

Cory Fowler practices at 3650 N University Ave Ste 200, Provo, UT 84604. The listed phone number is (801) 375-7102.

What is Cory Fowler's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Cory Fowler enrolled in Medicare?

No. Cory Fowler has opted out of Medicare through January 29, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Cory Fowler was last updated on July 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.