Individual provider Active NPI

Victoria L.S. Owens, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Goshen, IN
National Provider Identifier
1073777892
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
01074115A Issued in IN
Practice address
200 High Park Ave
Goshen, IN 46526-4810
Phone
(574) 364-1000
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 01074115A IN Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 52026 MN

Addresses

Primary practice location

200 High Park Ave
Goshen, IN 46526-4810

Mailing address

200 High Park Ave
Goshen, IN 46526-4810
Phone (574) 364-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140827001482 IN Practitioner - Pathology 9638216385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Toledo Medical College, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goshen Hospital Association IncGroup PAC ID 5991770695, 10 clinicians

Practice addresses (Care Compare)

200 High Park Ave
Goshen, IN 46526-4810
Phone (219) 533-2141

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52026MNMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Hospital Association Inc CurrentSince Sep 2, 2014 Accepting new patients
Goshen Hospital Association Inc PastSince Sep 23, 2021 Accepting new patients

Locations

200 High Park Ave
Goshen, IN 46526
Phone (219) 533-2141

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1073777892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HIGH PARK AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264810",
            "telephone_number": "574-364-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HIGH PARK AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264810",
            "telephone_number": "574-364-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "VICTORIA",
        "middle_name": "L.S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01074115A",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MN",
            "license": "52026",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

Verify at the official NPI Registry.