ELISABETH DOWLEN
NPI 1265894612
Pediatrics in Clemmons, NC
NPI Status: Active since March 24, 2016
Contact Information
5175 OLD CLEMMONS SCHOOL RD
CLEMMONS, NC
ZIP 27012
Phone: (336) 718-3950
Fax: (336) 766-3691
- Individual
- Female
- Pediatrics
- Accepts Insurance
- PECOS Enrolled
About ELISABETH DOWLEN
This page provides the complete NPI Profile along with additional information for Elisabeth Dowlen, a pediatrician established in Clemmons, North Carolina with a medical specialization in Pediatrics. The healthcare provider is registered in the NPI registry with number 1265894612 assigned on March 2016. The practitioner's primary taxonomy code is 208000000X with license number 2019-00605 (NC). The provider is registered as an individual and her NPI record was last updated 5 years ago.
- NPI
- 1265894612
- Provider Name
- ELISABETH DOWLEN
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 5175 OLD CLEMMONS SCHOOL RD CLEMMONS, NC 27012
- Location Phone
- (336) 718-3950
- Location Fax
- (336) 766-3691
- Mailing Address
- PO BOX 751803 CHARLOTTE, NC 28275
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-24-2016
- Last Update Date
- 10-26-2020
- Code Navigator
A pediatrician like Elisabeth Dowlen is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Secondary Locations
- Wake Forest Baptist Medical Ctr 1 Medical Center Drive
Winston Salem, NC 27157
(336) 716-2011 - Wake Forest Baptist Medical Ctr 1 Medical Center Drive
Winston Salem, NC 27157
(336) 716-2011
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics
- Taxonomy Code
- 208000000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 2019-00605
- License State
- NC
- Taxonomy Description
- A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Bronze Standard | Nationwide Doctors - PPO
- Blue Advantage Gold Premier | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Gold Standard | Nationwide Doctors - PPO
- Blue Advantage Silver Choice | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Silver Standard | Nationwide Doctors - PPO
- Blue Care Bronze Standard | Statewide Doctors - HMO
- Blue Care Gold Standard | Statewide Doctors - HMO
- Blue Care Silver Standard | Statewide Doctors - HMO
- Blue Home Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | with Novant Health - EPO
- Blue Home Bronze Standard | with Novant Health - EPO
- Blue Home Gold Premier | 3 Free PCP | $10 Tier 1 Rx | with Novant Health - EPO
- Blue Home Gold Standard | with Novant Health - EPO
- Blue Home Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | with Novant Health - EPO
- Blue Home Silver Standard | with Novant Health - EPO
- Blue Value Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | Limited Statewide Doctors - POS
- Blue Value Bronze Complete | $60 PCP | $20 Tier 1 Rx | Limited Statewide Doctors - POS
- Blue Value Bronze Standard | Limited Statewide Doctors - POS
- Bronze First 7500 $25 Generic Drugs - HMO
- Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
- Core Gold 1500 $10 Generic Drugs - HMO
- Core Gold 1500 $10 Generic Drugs Adult Vision & Fitness - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Gold 1500 $15 Generic Drugs - HMO
- Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
- HDHP Preventive Silver 5500 $0 Select Drugs - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Low Premium Silver 6000 $3 Generic Drugs - HMO
- Low Premium Silver 6000 $3 Generic Drugs Adult Vision & Fitness - HMO
- Silver 5000 $20 Generic Drugs - HMO
- Silver 5000 $20 Generic Drugs Adult Vision & Fitness - HMO
- Connect Bronze 5500 Indiv Med Deductible - HMO
- Connect Bronze 6500 Indiv Med Deductible - HMO
- Connect Bronze CMS Standard - HMO
- Connect Gold CMS Standard - HMO
- Connect Silver 3500 Indiv Med Deductible - HMO
- Connect Silver 4400 Indiv Med Deductible - HMO
- Connect Silver CMS Standard - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Bronze Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Silver Standard (No Referrals) - HMO
- UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- Standard Expanded Bronze WellCare - PPO
- Standard Gold WellCare - PPO
- Standard Silver WellCare - PPO
- WellCare Secure Health Bronze - PPO
- WellCare Secure Health Gold - PPO
- WellCare Secure Health Silver - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Elisabeth Dowlen is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 27012 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $83.9
- Minimum New Patient Price $54.12
- Maximum New Patient Price $165.09
- Average New Patient Copayment $20.97
- Minimum New Patient Copayment $13.53
- Maximum New Patient Copayment $41.27
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $95.94
- Minimum Established Patient Price $17.21
- Maximum Established Patient Price $134.61
- Average Established Patient Copayment $23.98
- Minimum Established Patient Copayment $4.3
- Maximum Established Patient Copayment $33.65
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 6 | 5 | 8 | 9 | 4 | 6 | 1 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 12 | 5 | 16 | 9 | 8 | 6 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 2 + 5 + 1 + 6 + 9 + 8 + 6 + 2 + 24 = 68 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 68 = 2 | 2 | ||||||||
The NPI number 1265894612 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 6 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1689917783 | NOVANT MEDICAL GROUP Organization | Dietitian, Registered | 5175 OLD CLEMMONS SCHOOL RD CLEMMONS, NC 27012 (336) 718-6770 |
| 1750933719 | KELSEY GEORGE Individual | Behavior Technician | 5175 OLD CLEMMONS SCHOOL RD CLEMMONS, NC 27012 (704) 780-4271 |
| 1164152245 | ALEXANDRA JANE TALBERT PA-C Individual | Physician Assistant | 5175 OLD CLEMMONS SCHOOL RD CLEMMONS, NC 27012 (336) 718-3960 |
| 1235700386 | AUSTIN CHAPMAN-LOVETTE CROMER PA-C Individual | Physician Assistant | 5175 OLD CLEMMONS SCHOOL RD CLEMMONS, NC 27012 (336) 718-3960 |
| 1255002721 | NOVANT HEALTH MEDICAL GROUP, LLC Organization | Pediatrics | 5175 OLD CLEMMONS SCHOOL RD CLEMMONS, NC 27012 (336) 718-3960 |
| 1508684127 | VIRGINIA ROEHM HAMILTON PA Individual | Physician Assistant | 5175 OLD CLEMMONS SCHOOL RD CLEMMONS, NC 27012 (336) 718-3960 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1265894612, enumerated in the NPI registry as an "individual" on March 24, 2016
The provider is located at 5175 Old Clemmons School Rd Clemmons, Nc 27012 and the phone number is (336) 718-3950
The provider's speciality is Pediatrics with taxonomy code 208000000X
The provider might be accepting Accepts: Blue Cross and Blue Shield of NC, CareSource,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $83.9 with an average copayment of $20.97 for new patient appointments. Established patients should expect a typical charge of $95.94 and an average copayment of 23.98. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on March 24, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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