Individual provider Active NPI

Roger K Owens, PA-C

  • Physician Assistant
  • Flemingsburg, KY
National Provider Identifier
1104895234
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-084 Issued in KY
Practice address
169 Medical Park Drive
Flemingsburg, KY 41041
Phone
(606) 849-2675
Fax
(606) 849-2658
NPI assigned
Mar 14, 2006
Last updated
Dec 4, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-084 KY Primary

Addresses

Primary practice location

169 Medical Park Drive
Flemingsburg, KY 41041

Mailing address

901 Kenton Station Dr
Maysville, KY 41056-9609
Phone (606) 759-9353

Other identifiers 2

IdentifierTypeStateIssuer
9500533600MedicaidKY
6293OtherKYKY MEDICARE GROUP #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050531000281 KY Practitioner - Physician Assistant 4183691165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1115 Progress Way
Maysville, KY 41056-9688
Phone (606) 759-4442

989 Medical Park Dr
Maysville, KY 41056-8750
Phone (606) 759-3585

991 Medical Dr
Suite 207
Maysville, KY 41056-8728
Phone (606) 759-4852

991 Medical Park Dr
Maysville, KY 41056-8728

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-084KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Meadowview Physician Practice LLC CurrentSince Feb 17, 2015 Accepting new patients
Meadowview Physician Practice LLC CurrentSince Feb 17, 2015 Accepting new patients
Ohio Valley Heart, P.S.C. Physician Assistant Past Accepting new patients
Meadowview Physician Practice LLC Past Accepting new patients

Locations

901 Kenton Station Dr
Maysville, KY 41056
Phone (606) 759-5337

989 Medical Park Dr
Maysville, KY 41056
Phone (606) 759-3112

991 Medical Park Dr
Ste 201
Maysville, KY 41056
Phone (606) 759-3585

991 Medical Park Dr
Ste 202
Maysville, KY 41056
Phone (606) 759-5424

Interoperability endpoints

  • Direct secure messaging: roger.owens.1@19475.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1104895234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 KENTON STATION DR",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410569609",
            "telephone_number": "606-759-9353",
            "fax_number": "606-759-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 MEDICAL PARK DRIVE",
            "city": "FLEMINGSBURG",
            "state": "KY",
            "postal_code": "41041",
            "telephone_number": "606-849-2675",
            "fax_number": "606-849-2658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "ROGER",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA-084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9500533600",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICARE GROUP #",
            "identifier": "6293",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flemingsburg, KY

Sources for this page

Verify at the official NPI Registry.