Organization Active NPI

Kerry C Owens MD PC

  • Specialist
  • Oklahoma City, OK
National Provider Identifier
1205020765
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
20074 Issued in OK
Legal business name
KERRY C OWENS MD PC
Practice address
3400 NW Expressway
Suite 800
Oklahoma City, OK 73112-4493
Phone
(405) 552-2961
NPI assigned
Aug 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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

Authorized official

Name
Kerry C Owens, MDNPI 1578523148
Title
President
Phone
(405) 552-2963

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 20074 OK Primary

Addresses

Primary practice location

3400 NW Expressway
Suite 800
Oklahoma City, OK 73112-4493

Mailing address

3400 NW Expressway
Suite 800
Oklahoma City, OK 73112-4493
Phone (405) 552-2961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040930000030 OK Part B Supplier - Clinic/Group Practice 9739158304 Receives reassigned benefits from 1 practitioner
Practice locations: Elk City, OK; Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

1901 W 3rd St
Elk City, OK 73644
Phone (580) 225-1086

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188259200000",
    "number": "1205020765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 NW EXPRESSWAY",
            "address_2": "SUITE 800",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124493",
            "telephone_number": "405-552-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 NW EXPRESSWAY",
            "address_2": "SUITE 800",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124493",
            "telephone_number": "405-552-2961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERRY C OWENS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-552-2963",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "OK",
            "license": "20074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.