Individual provider Active NPI

Jacqueline Owen, FNP-BC, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lumberton, NC
National Provider Identifier
1215171608
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5018816 Issued in NC
Practice address
405 Dunn Rd # 405a
Lumberton, NC 28358-7913
Phone
(910) 738-7865
Fax
(910) 738-2860
NPI assigned
Apr 29, 2009
Last updated
Jul 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5018816 NC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5018816 NC Primary

Addresses

Primary practice location

405 Dunn Rd # 405a
Lumberton, NC 28358-7913

Mailing address

405 Dunn Rd # 405a
Lumberton, NC 28358-7913
Phone (910) 738-7865

Other practice location 1

13104 Nc Highway 130 E
Fairmont, NC 28340-9597
Phone (910) 535-4123

Other practice location 2

1880 S 17th St
Wilmington, NC 28401-6444
Phone (910) 399-6831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20231115001109 NC Practitioner - Nurse Practitioner 5991856296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wilmington Mental Health PLLCGroup PAC ID 8325439201, 11 clinicians

Practice addresses (Care Compare)

3825 Market St
Suite 4
Wilmington, NC 28403-1426
Phone (910) 777-5575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wilmington Mental Health, PLLC Family CurrentSince Sep 14, 2023 Accepting new patients

Locations

3825 Market St
Ste 4
Wilmington, NC 28403
Phone (910) 777-5575

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1215171608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 DUNN RD # 405A",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283587913",
            "telephone_number": "910-738-7865",
            "fax_number": "910-738-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 DUNN RD # 405A",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283587913",
            "telephone_number": "910-738-7865",
            "fax_number": "910-738-2860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13104 Nc Highway 130 E",
            "address_purpose": "LOCATION",
            "city": "Fairmont",
            "state": "NC",
            "postal_code": "283409597",
            "country_code": "US",
            "telephone_number": "910-535-4123",
            "fax_number": "910-535-4199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1880 S 17th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284016444",
            "country_code": "US",
            "telephone_number": "910-399-6831",
            "fax_number": "910-399-6841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWEN",
        "first_name": "JACQUELINE",
        "name_prefix": "Ms.",
        "credential": "FNP-BC, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-29",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5018816",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5018816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

Verify at the official NPI Registry.