Active NPI
Elbert Wynn Owens
- Counselor
- Marion, SC
National Provider Identifier
1063538965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 702 Bluff St
Marion, SC 29571-3804 - Phone
- (843) 431-1105
- Fax
- (843) 431-1112
- NPI assigned
- Mar 22, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
702 Bluff St
Marion, SC 29571-3804
Mailing address
125 E. Cheves St.
Florence, SC 29506
Phone (843) 317-4089
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 376241 | Medicaid | SC |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063538965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 E. CHEVES ST.",
"city": "FLORENCE",
"state": "SC",
"postal_code": "29506",
"telephone_number": "843-317-4089",
"fax_number": "843-317-4096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 BLUFF ST",
"city": "MARION",
"state": "SC",
"postal_code": "295713804",
"telephone_number": "843-431-1105",
"fax_number": "843-431-1112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OWENS",
"first_name": "ELBERT",
"middle_name": "WYNN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "376241",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marion, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.