Individual provider Active NPI

Alexander E Osowa, MD

  • Family Medicine Physician
  • Jackson, MS
National Provider Identifier
1316910755
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34412 Issued in MS
Practice address
4541 N State St
Jackson, MS 39206-5308
Phone
(601) 533-7017
NPI assigned
Feb 8, 2006
Last updated
Mar 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 57551 GA
Family Medicine Physician 207Q00000X 34412 MS Primary

Addresses

Primary practice location

4541 N State St
Jackson, MS 39206-5308

Mailing address

PO Box 746085
Atlanta, GA 30374-6085
Phone (469) 727-6675

Other practice location 1

3331 Hamilton Mill Road
Suite 1102
Buford, GA 30519
Phone (678) 541-0588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060602000005 GA Practitioner - Family PracticePractitioner - Geriatric Medicine 2365431277 Reassigns benefits to 1 organization
I20250320002309 MS Practitioner - Family Practice 2365431277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health Physicians Group of Mississippi, LLCGroup PAC ID 7012334170, 16 clinicians

Practice addresses (Care Compare)

4541 N State St
Jackson, MS 39206-5308
Phone (601) 533-7017

911 Ellis Ave
Jackson, MS 39209-6256
Phone (601) 533-7016

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57551GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group of Mississippi, LLC Family Medicine CurrentSince Mar 17, 2025 Accepting new patients
Buford Family Practice and Urgent Care Center, P.C CurrentSince Jun 1, 2006 Accepting new patients
Community Family Practice and Urgent Care P C Family Medicine CurrentSince Oct 6, 2010 Accepting new patients
National Emergency Services North Carolina Inc Past Accepting new patients
Crawford County Memorial Hospital Past Accepting new patients
Crawford County Memorial Hospital Family Medicine Past Accepting new patients
McFatter Family Medical, LLC Past Accepting new patients

Locations

3331 Hamilton Mill Rd
Ste 1102
Buford, GA 30519
Phone (678) 541-0588

4541 N State St
Jackson, MS 39206
Phone (601) 533-7017

911 Ellis Ave
Jackson, MS 39209
Phone (601) 533-7016

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1316910755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746085",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746085",
            "telephone_number": "469-727-6675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4541 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392065308",
            "telephone_number": "601-533-7017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3331 HAMILTON MILL ROAD",
            "address_2": "SUITE 1102",
            "address_purpose": "LOCATION",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "30519",
            "country_code": "US",
            "telephone_number": "678-541-0588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSOWA",
        "first_name": "ALEXANDER",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "57551",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "34412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.