Individual provider Active NPI

Stephanie Marie Owen, FNP-C

  • Nurse Practitioner
  • Mount Carmel, IL
National Provider Identifier
1316769169
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.030920 Issued in IL
Practice address
1106 Oak St
Mount Carmel, IL 62863-2444
Phone
(618) 263-6575
Fax
(618) 262-4468
NPI assigned
Oct 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.030920 IL
Primary Care Nurse Practitioner 363LP2300X 209.030920 IL
Nurse Practitioner 363L00000X 209.030920 IL Primary

Addresses

Primary practice location

1106 Oak St
Mount Carmel, IL 62863-2444

Mailing address

1106 Oak St
Mount Carmel, IL 62863-2444
Phone (618) 263-6575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20241226001892 IL Practitioner - Nurse Practitioner 1658808985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wabash General Hospital DistrictGroup PAC ID 8022908185, 77 clinicians

Practice addresses (Care Compare)

1418 College Dr
Mount Carmel, IL 62863-2638
Phone (618) 262-8621

1430 College Dr
Suite B
Mount Carmel, IL 62863-2649
Phone (618) 263-6190

1527 College Dr
Mount Carmel, IL 62863-2615
Phone (618) 263-6400

610 N Court St
Grayville, IL 62844-1002
Phone (618) 375-7101

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.030920ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wabash General Hospital District Current Accepting new patients
Wabash General Hospital District CurrentSince Jan 1, 2025 Accepting new patients
Wabash General Hospital District CurrentSince Jan 1, 2025 Accepting new patients
Wabash General Hospital District Past Accepting new patients

Locations

1418 College Dr
Mount Carmel, IL 62863
Phone (618) 262-8621

1106 Oak St
Mount Carmel, IL 62863
Phone (618) 263-6575

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1316769169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 OAK ST",
            "city": "MOUNT CARMEL",
            "state": "IL",
            "postal_code": "628632444",
            "telephone_number": "618-263-6575",
            "fax_number": "618-262-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 OAK ST",
            "city": "MOUNT CARMEL",
            "state": "IL",
            "postal_code": "628632444",
            "telephone_number": "618-263-6575",
            "fax_number": "618-262-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.030920",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209.030920",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.030920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Carmel, IL

Sources for this page

Verify at the official NPI Registry.