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THOMAS W FOWLES MD
NPI 1285679100
Family Medicine in Mount Vernon, KY

Active since June 17, 2006PECOS Enrolled
942 W MAIN ST UNIT B, MOUNT VERNON, KY 40456(606) 392-2207(606) 392-2139 Get Directions Write a Review

NPPES record last updated: May 26, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 26, 2020, Mar 17, 2018, Feb 15, 2018 (3 updates tracked since 2018).

About Thomas W Fowles Md NPPES

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

THOMAS W FOWLES MD (NPI 1285679100) is an individual family medicine provider in Mount Vernon, Kentucky, licensed in Kentucky (38140) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Berea, and is a graduate of University Of Louisville School Of Medicine (2001).

NPPES Registry Identity

NPI1285679100
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameTHOMAS W FOWLESCredential: MD
Location Address942 W MAIN ST UNIT BMount Vernon, KY 40456-2523
Mailing Address942 W Main St Unit BMount Vernon, KY 40456-2523 · (731) 571-9223 · Fax (931) 901-1239
Phone(606) 392-2207
Fax(606) 392-2139
Sole ProprietorNo
Medical School CMSUniversity Of Louisville School Of MedicineGraduated 2001
Enumeration DateJune 17, 2006
Last NPPES UpdateMay 26, 20203 updates tracked since enumeration
NPPES CertifiedMay 26, 2020
✔ NPI 1285679100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in KY · 38140
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
942 W MAIN ST UNIT B, Mount Vernon, KY 40456
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Secondary Practice Location 1

Location 1133 Plaza Dr Ste 3Berea, KY 40403-2087 · Phone (859) 986-1370 · Fax (859) 986-1374

Other Identifiers 4

Other261QP2300XKY · Primary Care Physician
Medicaid64102726KY
OtherP00372184KY · Railroad Medicare
Other38140KY · Family Practice

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Thomas W Fowles Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7810928058
PECOS Enrollment IDI20050826000495
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 Reassignments

4

Medicare enrollment records show Thomas Fowles reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Letek PLLC
1.0 mi
Primary Care
75 EAST MAIN STREET
Mount Vernon, KY 40456
  • Reassigned Medicare billing, Kentucky enrollment
NPI 1043766801 (859) 358-1023
Berea Urgent Care LLC
15 mi
Nurse Practitioner
234 BRENWOOD ST
Berea, KY 40403
  • Reassigned Medicare billing, Kentucky enrollment
  • 69 clinicians in this Medicare group
NPI 1912054792 (859) 985-0302
Medical Laser Center LLC
15 mi
Rural Health
133 PLAZA DR, SUITE 3
Berea, KY 40403
  • Reassigned Medicare billing, Kentucky enrollment
  • 3 clinicians in this Medicare group
NPI 1649401563 (859) 986-1370
Georgetown Urgent Care PLLC
61 mi
Urgent Care
111 OSBOURNE WAY, SUITE 101
Georgetown, KY 40324
  • Reassigned Medicare billing, Kentucky enrollment
  • 66 clinicians in this Medicare group
NPI 1780838847 (859) 466-8956

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 40456 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier12 claims12 services$180.63 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Thomas Fowles's NPI number?

The NPI number for Thomas Fowles is 1285679100. It was assigned to this individual provider in the NPPES registry on June 17, 2006.

Where is Thomas Fowles located?

Thomas Fowles practices at 942 W Main St Unit B, Mount Vernon, KY 40456. The listed phone number is (606) 392-2207.

What is Thomas Fowles's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Thomas Fowles enrolled in Medicare?

Yes. Thomas Fowles is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Thomas Fowles's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thomas Fowles reassigns Medicare benefits to 4 organizations: Letek PLLC (Mount Vernon, KY), Berea Urgent Care LLC (Berea, KY), Medical Laser Center LLC (Berea, KY) and Georgetown Urgent Care PLLC (Georgetown, KY). Each 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 Thomas Fowles's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Thomas Fowles accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee, Anthem Blue Cross and Blue Shield and UnitedHealthcare list Thomas Fowles as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Thomas Fowles was last updated on May 26, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.