Individual provider Active NPI

Johnie Louis Owens III, D.O.

  • Family Medicine Physician
  • Pryor, OK
National Provider Identifier
1104846732
Registry record updated May 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4430 Issued in OK
Practice address
562 S Elliott St
Pryor, OK 74361-6411
Phone
(918) 824-8000
Fax
(918) 825-5505
NPI assigned
Jul 19, 2006
Last updated
May 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2007021791 MO
Family Medicine Physician 207Q00000X 4430 OK Primary

Addresses

Primary practice location

562 S Elliott St
Pryor, OK 74361-6411

Mailing address

562 S Elliott St
Pryor, OK 74361-6411
Phone (918) 824-8000

Other identifiers 1

IdentifierTypeStateIssuer
200097040AMedicaidOK

Other names 1

  • Dr. John L Owens Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20130830000786 OK Practitioner - Family PracticePractitioner - Osteopathic Manipulative MedicinePractitioner - Emergency Medicine 8426131590 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahs Pryor Hospital, LLCGroup PAC ID 3072880624, 7 clinicians

Practice addresses (Care Compare)

1301 NE 1St St
Pryor, OK 74361-8851
Phone (918) 824-7714

562 S Elliott St
Pryor, OK 74361-6411
Phone (918) 825-6334

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4430OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Resource Management, LLC Family Medicine CurrentSince Jan 28, 2017 Accepting new patients
Ahs Pryor Hospital, LLC CurrentSince Apr 2, 2024 Accepting new patients
Ahs Oklahoma Physician Group LLC Family Medicine CurrentSince Jul 1, 2013 Accepting new patients
Medexpress Urgent Care, PC - Oklahoma CurrentSince Sep 3, 2015 Accepting new patients
Ahs Pryor Hospital, LLC Current Accepting new patients
Ahs Oklahoma Physician Group, LLC CurrentSince Jul 1, 2013 Accepting new patients
Saint Luke's Hospital of Trenton Past Accepting new patients

Locations

16205 N Pennsylvania Ave
Edmond, OK 73013
Phone (405) 512-6950

3428 NW Cache Rd
Lawton, OK 73505
Phone (580) 595-7207

10701 N Rockwell Ave
Oklahoma City, OK 73162
Phone (405) 470-1500

1301 NE 1st St
Ste 400
Pryor, OK 74361
Phone (918) 824-7714

562 S Elliott St
Pryor, OK 74361
Phone (918) 824-8000

20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675

2929 S Garnett Rd
Tulsa, OK 74129
Phone (918) 665-1520

Dept 1206
Tulsa, OK 74182

Interoperability endpoints

  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jowens113194@ahs.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Vialife Hospice LLCPryor, OK, CCN 371720 Hospice Contracted Managing Employee Jun 8, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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

Hospital & facility affiliations 4

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399334400000",
    "number": "1104846732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "562 S ELLIOTT ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743616411",
            "telephone_number": "918-824-8000",
            "fax_number": "918-825-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "562 S ELLIOTT ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743616411",
            "telephone_number": "918-824-8000",
            "fax_number": "918-825-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "JOHNIE",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2014-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2007021791",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "4430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200097040A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "OWENS",
            "middle_name": "L",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Pryor, OK

Sources for this page

Verify at the official NPI Registry.