Charles M Owens OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618000347 Issued in VA

Legal business name

CHARLES M OWENS OD PC

Practice address

5057 Dickenson Hwy
Clintwood, VA 24228-6078

Phone

(276) 926-8776

Fax

(276) 926-4375

NPI assigned

May 4, 2007

Last updated

Dec 30, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles M Owens, OD

Title

Owner

Phone

(276) 926-4375

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262131200000",
    "number": "1174735823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5057 DICKENSON HWY",
            "city": "CLINTWOOD",
            "state": "VA",
            "postal_code": "242286078",
            "telephone_number": "276-926-8776",
            "fax_number": "276-926-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5057 DICKENSON HWY",
            "city": "CLINTWOOD",
            "state": "VA",
            "postal_code": "242286078",
            "telephone_number": "276-926-8776",
            "fax_number": "276-926-4375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES M OWENS OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2009-12-30",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "276-926-4375",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009236341",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Clintwood, VA
• Providers in Clintwood, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.