Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Matthew Fowler, AGNP-C

Individual provider Nurse Practitioner · NPI 1053943688

Matthew Fowler, AGNP-C is a Nurse Practitioner in Nampa, Idaho. Qualified in 2019, 7 years ago. Practices with Meridian Advanced Psychiatry , LLC, a 25-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
7
Licensed in
ID
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

1611 12th Ave Rd Ste A
Nampa, ID 83686-6182
Phone: (208) 546-3650
Fax: (208) 505-1947
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 63745 (ID)
Nurse Practitioner Taxonomy 363L00000X · Licence 63745 (ID)

Record details

NPI number1053943688
Entity typeIndividual (Type 1)
GenderMale
Credentials AGNP-C
Sole proprietorNo
NPI enumeratedFebruary 11, 2020
Last updated in NPPESSeptember 22, 2025
Certification dateSeptember 22, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Meridian Advanced Psychiatry , Llc — 25 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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