DR. TRISTAN ROSS PEREGRINO FOWLER (NPI# 1881044006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881044006 |
| Entity Type | Individual |
| Full Name | DR. TRISTAN ROSS PEREGRINO FOWLER |
| Credential | DO |
| Practice Address |
4840 College Blvd Overland Park KS 66211-1601 |
| Practice Telephone | 9134916878 |
| Practice Fax Number | 9134913172 |
| Mailing Telephone | 9134916878 |
| Mailing Fax Number | 9134913172 |
| Enumeration Date | 2016-06-18 |
| Last Update Date | 2020-08-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 05-43441 | KS | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | 5101022338 | MI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1215 E Michigan Ave, Lansing, MI 489121811 | 5173645610 | 5173642842 |
| Street Address |
4840 COLLEGE BLVD |
| City | OVERLAND PARK |
| State | KS |
| Zip Code | 66211-1601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255300893 | Herbert C Hodes | Obstetrics & Gynecology | 4840 College Blvd, Overland Park, KS 66211-1601 | 2006-03-16 |
| 1770942740 | Natalie Wellington | Nurse Practitioner | 4840 College Blvd, Overland Park, KS 66211-1601 | 2016-02-18 |
| 1174904379 | Sarah Pearl | Obstetrics & Gynecology | 4840 College Blvd, Overland Park, KS 66211-1601 | 2015-06-12 |
| 1346570991 | Hodes & Nauser Mds Pa | Obstetrics & Gynecology | 4840 College Blvd, Overland Park, KS 66211-1601 | 2010-01-04 |
| 1407912314 | Colleen A O'donnell | Nurse Practitioner | 4840 College Blvd, Overland Park, KS 66211-1601 | 2006-12-28 |
| 1790754349 | Traci L Nauser | Obstetrics & Gynecology | 4840 College Blvd, Overland Park, KS 66211-1601 | 2006-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336611821 | Baillie Rose Woydziak | Social Worker | 5805 W 110th Street, Overland Park, KS 66211 | 2018-12-20 |
| 1467920389 | Ku Medwest Ambulatory Surgery Center, LLC | Clinic/Center | 10720 Nall Avenue, Overland Park, KS 66211 | 2018-11-08 |
| 1235615931 | Janice Carollo | Physical Therapy Assistant | 11611 Granada Lane, Leawood, KS 66211 | 2018-07-16 |
| 1720572555 | Trevor Lee Elmer | Physical Therapist | 10777 Nall, 320 - Corporate Medical Plaza Building II, Overland Park, KS 66211 | 2018-06-15 |
| 1043746555 | Overland Park Surgical Suites, LLC | Clinic/Center | 6650 W 110th St Ste 300, Overland Park, KS 66211 | 2017-05-03 |
| 1619313665 | Vcphcs Xiv, LLC | Clinic/Center | 6331 W. 110th Street, Overland Park, KS 66211 | 2013-05-17 |
| 1528334950 | Scott Anthony Hardouin | Surgery | 5100 W 110th St Unit 300, Overland Park, KS 66211 | 2012-03-29 |
| 1386917003 | Children's Physical Therapy Associates | Physical Therapist | 6600 College Boulevard, Suite 307, Overland Park, KS 66211 | 2012-02-10 |
| 1871876250 | Amber Diane Dalzell | Social Worker | 10965 Granada Ln Ste 102, Overland Park, KS 66211 | 2011-09-22 |
| 1912298001 | Stephen Vincent Hiatt | Orthopaedic Surgery | 10701 Nall Avenue, Suite 200, Overland Park, KS 66211 | 2011-04-25 |
| Find all providers in zip 66211 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134511280 | Francis Gary Lockwood | Obstetrics & Gynecology | 6421 West 92nd Street, Overland Park, KS 66212-1373 | 2015-02-26 |
| 1437413069 | Mary Janelle Laughlin | Obstetrics & Gynecology | 13129 Bluejacket St, Overland Park, KS 66213-4632 | 2012-06-28 |
| 1669734950 | Jessica Elaine Parrott | Obstetrics & Gynecology | 12200 W 106th St Ste 110, Overland Park, KS 66215-2305 | 2012-06-12 |
| 1225134406 | Peter Joseph Caruso | Obstetrics & Gynecology | 12330 Metcalf Ave Ste 420, Overland Park, KS 66213-1307 | 2006-09-15 |
| 1710096755 | Timothy L. Bennett | Obstetrics & Gynecology | 5520 College Boulevard, Suite 480, Overland Park, KS 66211 | 2006-08-30 |
| 1073566774 | Kansas City Women's Clinic | Obstetrics & Gynecology | 10600 Quivira, Ste. 3rd Floor, Overland Park, KS 66215-2311 | 2006-05-17 |
| 1033176474 | John T Schroll Md Pa | Obstetrics & Gynecology | 12541 Foster St, Suite 220, Overland Park, KS 66213-2630 | 2006-04-28 |
| 1497715437 | Catherine A Gordon | Obstetrics & Gynecology | 9209 W. 110th Street, Building #36, Overland Park, KS 66210 | 2006-03-24 |
| 1871585075 | Cynthia K Drake | Obstetrics & Gynecology | 11364 W 121st Ter, Overland Park, KS 66213-1978 | 2005-08-16 |
| 1538165048 | Errick Y Arroyo | Obstetrics & Gynecology | 12200 W 106th St, Suite 230, Overland Park, KS 66215-2305 | 2005-06-21 |
| Find all providers in OVERLAND PARK | ||||
| City | OVERLAND PARK |
| Zip Code | 66211 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.