Individual provider Active NPI

Kameron Owens, LPN

  • Licensed Practical Nurse
  • Dayton, OH
National Provider Identifier
1235755448
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN.167456.MEDS-IV Issued in OH
Practice address
1102 Salem Ave Apt 2E
Dayton, OH 45406-5148
Phone
(937) 503-0272
NPI assigned
Jun 23, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164W00000X LPN.167456.MEDS-IV OH Primary

Addresses

Primary practice location

1102 Salem Ave Apt 2E
Dayton, OH 45406-5148

Mailing address

1102 Salem Ave Apt 2E
Dayton, OH 45406-5148
Phone (937) 503-0272

Other identifiers 1

IdentifierTypeStateIssuer
TZ667789OtherOHDRIVER LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 9375030272 Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN.167456.MEDS-IVOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1235755448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 SALEM AVE APT 2E",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454065148",
            "telephone_number": "937-503-0272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 SALEM AVE APT 2E",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454065148",
            "telephone_number": "937-503-0272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "KAMERON",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.167456.MEDS-IV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "TZ667789",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "9375030272",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1102 Salem Ave Apt 2E",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454065148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.