Stephanie Lynn Owen, MS, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2076 Issued in TN

Practice address

2410 Susannah St
Johnson City, TN 37601-1748

Phone

(423) 282-9011

Fax

(429) 282-0035

NPI assigned

May 15, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1245720382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 ROCKINGHAM RD APT 14",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154767",
            "telephone_number": "276-971-6806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 SUSANNAH ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011748",
            "telephone_number": "423-282-9011",
            "fax_number": "429-282-0035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 Larry Neil Way",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376606368",
            "country_code": "US",
            "telephone_number": "423-282-9011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWEN",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "MS, ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-15",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "2076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Outpatient Cytopathology Center
• Outreach Clinics Unlimited PLLC
• Carolyn H. Overbay, M.A.
• Paige B Overton, BS
• Vida Oveysi, PHARMD
• Abigail Diana Owens, DO
• Audra Owens, LPN
• Isaiah Owens
• Jack D Owens, MD
• Laura Elizabeth Owens, RN

• All providers in Johnson City, TN
• Athletic Trainer in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; 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.