Individual provider Active NPI

Wesley Owen, MD

  • Sports Medicine (Family Medicine) Physician
  • Germantown, TN
National Provider Identifier
1043743594
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
63329 Issued in TN
Practice address
1400 S Germantown Rd
Germantown, TN 38138-2205
Phone
(901) 759-3100
NPI assigned
Apr 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 63329 TN Primary

Addresses

Primary practice location

1400 S Germantown Rd
Germantown, TN 38138-2205

Mailing address

1400 S Germantown Rd
Germantown, TN 38138-2205
Phone (901) 759-3100

Other identifiers 2

IdentifierTypeStateIssuer
Q042350MedicaidTN
08035816MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210712001884 TN Practitioner - Family PracticePractitioner - Sports Medicine 2163799198 Reassigns benefits to 1 organization
I20210712003020 MS Practitioner - Family PracticePractitioner - Sports Medicine 2163799198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
University of Tennessee, HSC, College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Campbell Clinic, PCGroup PAC ID 9638082076, 229 clinicians

Practice addresses (Care Compare)

1400 S Germantown Rd
Germantown, TN 38138-2205
Phone (901) 759-3100

7545 Airways Blvd
Southaven, MS 38671-5806
Phone (901) 759-3196

Merit-based Incentive Payment System (MIPS)

Final score
75.09 of 100Reported as group
Quality
50.47
Promoting interoperability
99
Improvement activities
40
Cost
67.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell Clinic PC CurrentSince Jul 2, 2021 Accepting new patients
Campbell Clinic, PC Sports Medicine CurrentSince Jul 2, 2021 Accepting new patients
Campbell Clinic Past Accepting new patients
CC Bpci PLC Past Accepting new patients

Locations

2608 S Lamar Blvd
Ste 102
Oxford, MS 38655

7545 Airways Blvd
Southaven, MS 38671
Phone (901) 759-3196

1458 W Poplar Ave
Ste 100
Collierville, TN 38017
Phone (901) 759-5491

7887 Wolf River Blvd
Memphis, TN 38138
Phone (901) 759-3180

1211 Union Ave
Ste 500
Memphis, TN 38104
Phone (901) 759-3275

1400 S Germantown Rd
Memphis, TN 38138
Phone (901) 759-3111

585 S Mendenhall Rd
Memphis, TN 38117

Interoperability endpoints

  • Direct secure messaging: wowen34988@mlh.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/1366/brand/1/csg/1/fhir/r4
  • Direct secure messaging: wesley.owen.1@1366.direct.athenahealth.com

Organizations & group practices 4

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": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1043743594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S GERMANTOWN RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382205",
            "telephone_number": "901-759-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S GERMANTOWN RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382205",
            "telephone_number": "901-759-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-11",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TN",
            "license": "63329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q042350",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08035816",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.