Individual provider Active NPI

Audra Owens, LPN

  • Licensed Practical Nurse
  • Johnson City, TN
National Provider Identifier
1033947759
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
77843 Issued in TN
Practice address
102 N Broadway St
Johnson City, TN 37601-3525
Phone
(423) 588-9978
NPI assigned
Jul 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 77843 TN Primary

Addresses

Primary practice location

102 N Broadway St
Johnson City, TN 37601-3525

Mailing address

3919 Greenwood Dr Apt B
Jonesborough, TN 37659-6256
Phone (423) 863-8822

Other names 1

  • Audie Owens Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
77843TNMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Dragonfly Medical and Behavioral Health Professsional Corporation CurrentSince Jul 28, 2024 Accepting new patients
Dragfonfly Wellness Center PastSince Jul 28, 2024 Accepting new patients

Locations

102 N Broadway St
Johnson City, TN 37601
Phone (423) 588-9978

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1033947759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3919 GREENWOOD DR APT B",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376596256",
            "telephone_number": "423-863-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N BROADWAY ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376013525",
            "telephone_number": "423-588-9978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "AUDRA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "77843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDIE",
            "last_name": "OWENS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.