Individual provider Active NPI

Owen Tyler Owens, D.O.

  • Neurology Physician
  • Winston Salem, NC
National Provider Identifier
1083078869
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2020-03264 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-2123
Phone
(336) 716-2261
Fax
(336) 716-9810
NPI assigned
Apr 7, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 12288464-1204 UT
Neurology Physician 2084N0400X 2020-03264 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-2123

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2261

Other practice location 1

1380 E Medical Center Dr
St George, UT 84790-2123
Phone (435) 251-1000

Other practice location 2

Msc Neurology 1 University Of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-3160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, CO2 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
I20210623003249 UT Practitioner - Neurology 8123442563 Reassigns benefits to 3 organizations
I20250214001323 CO Practitioner - Neurology 8123442563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Western University of Health Sciences College of Dental Med, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Blue Sky Telehealth LLCGroup PAC ID 5395155964, 71 clinicians
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1847 S 2840
St George, UT 84790-1353
Phone (385) 286-4862

5600 S Quebec St
Suite 312a
Greenwood Village, CO 80111-2208
Phone (303) 343-6272

652 S Medical Ctr Dr
Suite 320
St George, UT 84790-7266
Phone (435) 251-3950

Hospital & facility affiliations

  • St. George Regional Hospital Hospital, St George, UT, CCN 460021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020-03264NCMDNeurology Physician
12288464-1204UTMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Neurology CurrentSince Jul 1, 2021 Accepting new patients
Blue Sky Telehealth, LLC Neurology CurrentSince Feb 1, 2025 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Jul 1, 2021 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Neurology CurrentSince Jan 1, 2025 Accepting new patients

Locations

5600 S Quebec St
Ste 312A
Greenwood Village, CO 80111
Phone (303) 343-6272

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

652 S Medical Center Dr
Ste 320
St George, UT 84790
Phone (435) 251-3950

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

Organizations & group practices 5

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": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1083078869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2261",
            "fax_number": "336-716-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271572123",
            "telephone_number": "336-716-2261",
            "fax_number": "336-716-9810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1380 E Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "St George",
            "state": "UT",
            "postal_code": "847902123",
            "country_code": "US",
            "telephone_number": "435-251-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Msc Neurology 1 University Of New Mexico",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871310001",
            "country_code": "US",
            "telephone_number": "505-272-3160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWENS",
        "first_name": "OWEN",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-07",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "UT",
            "license": "12288464-1204",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2020-03264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.