Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ethan Gerald Thomas Fowler, APRN-CNP

Individual provider Nurse Practitioner · NPI 1033917406

Ethan Gerald Thomas Fowler, APRN-CNP is a Nurse Practitioner in Columbus, Ohio. Qualified in 2023, 3 years ago. Practices with Osu Radiology LLC, a 180-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
3
Licensed in
OH
In the registry since
2025
Specialties on file
2
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Practice location Address checks out

410 W 10th Ave
Columbus, OH 43210-1240
Phone: (614) 293-3333
Fax: (614) 293-6935
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 460 W 10th Ave, Columbus, OH 43210-1240 — (800) 293-5066

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN.CNP.0034018 (OH)
Nurse Practitioner Taxonomy 363L00000X · Licence APRN.CNP.0034018 (OH)

Record details

NPI number1033917406
Entity typeIndividual (Type 1)
GenderMale
Credentials APRN-CNP
Sole proprietorNo
NPI enumeratedMarch 3, 2025
Last updated in NPPESApril 1, 2025
Certification dateApril 1, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Osu Radiology Llc — 180 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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