Physician Compare National (NPI:1962677708)

HEALTHCARE PROVIDER: JASON LEE FOWLER P.T.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1962677708
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7719056944
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080514000509
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FOWLER
	Individual professional last name
Provider First Name	JASON
	Individual professional first name
Provider Middle Name	LEE
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2001
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL THERAPY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	COMMONWEALTH PAIN ASSOCIATES PLLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0941441919
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	48
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1107 CROWN POINTE DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 107
	Group Practice or individual's line 2 address
City	ELIZABETHTOWN
	Group Practice or individual's city
State	KY
	Group Practice or individual's state
Zip Code	427017280
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2705063300
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y