Dale D Owen Jr., MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301089155 Issued in MI

Practice address

1420 Plaza Dr
Petoskey, MI 49770-9420

Phone

(231) 347-6701

NPI assigned

Nov 30, 2006

Sex

Male

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

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Munson Healthcare Charlevoix Hospital

  dba Physician Clinic of Charlevoix

  • Pediatrics Physician
  • Charlevoix, MI
  • NPI 1326124058
  Medicare reassignment NPD
• Munson Healthcare Charlevoix Hospital

  dba Munson Healthcare Boyne Area Health Center

  • Family Medicine Physician
  • Boyne City, MI
  • NPI 1790867216
  Medicare reassignment NPD
• Munson Healthcare Charlevoix Hospital

  dba Munson Healthcare Boyne Area Medical Center

  • Rural Health Clinic/Center
  • Boyne City, MI
  • NPI 1255779484
  NPD
• Munson Healthcare Charlevoix Hospital

  dba Munson Healthcare Charlevoix Walk-In Clinic

  • Family Medicine Physician
  • Charlevoix, MI
  • NPI 1972367043
  NPD
• North Country Community Mental Health

  • Community/Behavioral Health Agency
  • Petoskey, MI
  • NPI 1881060549
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1295803138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 PLAZA DR",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709420",
            "telephone_number": "231-347-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 PLAZA DR",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709420",
            "telephone_number": "231-347-6701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14695 Park Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Charlevoix",
            "state": "MI",
            "postal_code": "497201920",
            "country_code": "US",
            "telephone_number": "231-547-8860",
            "fax_number": "231-392-7335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "223 N Park St",
            "address_purpose": "LOCATION",
            "city": "Boyne City",
            "state": "MI",
            "postal_code": "497121220",
            "country_code": "US",
            "telephone_number": "231-582-5314",
            "fax_number": "231-582-5338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWEN",
        "first_name": "DALE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301089155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Ann Orr, M.D.
• Orthosport Physical Therapy and Athletic Rehabilitation Inc.
• James J Osetek, DMD
• Wesley Burl Ostrander, RPH
• Naomi A Overton, MD
• Wilfred Vincent Pacatang, DO
• Caroline Paige, LLMSW, CADC-DP
• Harry Ted Pall Jr., M.D.
• Jessica Panoff, PA-C
• Vincent Paone

• Psychiatry Physician in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.