Individual provider Active NPI

Medge Denise Owen, MD

  • Anesthesiology Physician
  • Winston Salem, NC
National Provider Identifier
1225013352
Registry record updated Sep 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
9400119 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone
(336) 716-2255
NPI assigned
Dec 13, 2005
Last updated
Sep 8, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 9400119 NC Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X 9400119 NC

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-0001

Mailing address

PO Box 344
Winston Salem, NC 27102-0344
Phone (336) 716-2255

Other identifiers 7

IdentifierTypeStateIssuer
64431OtherNCBCBS
3810001337MedicaidWV
5701694MedicaidVA
7003887MedicaidNC
7775333OtherAETNA
63974OtherNCMEDCOST
8248OtherNCPARTNERS

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090922000540 NC Practitioner - Anesthesiology 0648326355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Kansas School of Med (KC/Wich/Sal), 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Aug 10, 2009 Accepting new patients

Locations

2000 Frontis Plaza Blvd
Ste 300
Winston Salem, NC 27103
Phone (336) 659-3300

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: mowen2753050@carolinashealthcaresystem.direct-ci.com

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504828800000",
    "number": "1225013352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 344",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271020344",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "MEDGE",
        "middle_name": "DENISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2017-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "9400119",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NC",
            "license": "9400119",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "64431",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810001337",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5701694",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7003887",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7775333",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "63974",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "8248",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.