Individual provider Active NPI

Kelly Christina Owens

  • Women's Health Nurse Practitioner
  • Newport News, VA
National Provider Identifier
1124406871
Registry record updated Aug 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
0024172522 Issued in VA
Practice address
11747 Jefferson Ave Ste 6C
Newport News, VA 23606-1998
Phone
(757) 870-6803
NPI assigned
May 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024172522 VA
Women's Health Nurse Practitioner 363LW0102X 0024172522 VA Primary

Addresses

Primary practice location

11747 Jefferson Ave Ste 6C
Newport News, VA 23606-1998

Mailing address

248 Weatherford Way
Newport News, VA 23602-7579
Phone (757) 870-6803

Other practice location 1

8600 Quioccasin Rd
Richmond, VA 23229-5514
Phone (757) 870-6803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024172522VAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
K.O. Health Services, LLC Current Accepting new patients
Greenbrook TMS Roanoke PastSince Nov 21, 2017 Accepting new patients

Locations

11747 Jefferson Ave
Ste 6C
Newport News, VA 23606
Phone (757) 289-8471

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.

NPI Registry JSON

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661644800000",
    "number": "1124406871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 WEATHERFORD WAY",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236027579",
            "telephone_number": "757-870-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11747 JEFFERSON AVE STE 6C",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236061998",
            "telephone_number": "757-870-6803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8600 Quioccasin Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232295514",
            "country_code": "US",
            "telephone_number": "757-870-6803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWENS",
        "first_name": "KELLY",
        "middle_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-14",
        "last_updated": "2022-08-28",
        "certification_date": "2022-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024172522",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "VA",
            "license": "0024172522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.