Organization Active NPI

Feagin & Owen, M.D.., P.C.

  • Medical Specialty Clinic/Center
  • Dothan, AL
National Provider Identifier
1346490604
Registry record updated Oct 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
7921 Issued in AL
Legal business name
FEAGIN & OWEN, M.D.., P.C.
Practice address
4300 W Main St
Suite 43
Dothan, AL 36305-1054
Phone
(334) 793-7211
Fax
(334) 793-5425
NPI assigned
Sep 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2008

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

Authorized official

Name
Kimberly C Byrd
Title
Insurance
Phone
(334) 793-7211

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 7921 AL Primary
Medical Specialty Clinic/Center 261QM2500X 13944 AL

Addresses

Primary practice location

4300 W Main St
Suite 43
Dothan, AL 36305-1054

Mailing address

4300 W Main St
Suite 43
Dothan, AL 36305-1054
Phone (334) 793-7211

Other identifiers 7

IdentifierTypeStateIssuer
000011782MedicaidAL
000082133MedicaidAL
1427141282OtherALINDIVIDUAL NPI FOR DR. CHARLES FEAGIN
1619062064OtherALINDIVIDUAL NPI FOR DR. WILLIAM I. OWEN
11782OtherALBCBS OF ALABAMA PROVIDER NUMBER -- CHARLES FEAGIN, M.D.
82133OtherALBCBS OF ALABAMA PROVIDER FOR DR. WILLIAM I. OWEN, JR
529001560OtherALALABAMA MEDICAID PAYEE ID: 529001560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060112000678 AL Part B Supplier - Clinic/Group Practice 6406879782 Receives reassigned benefits from 2 practitioners
Practice locations: Dothan, AL

National Provider Directory

National Provider Directory

Locations

4300 W Main St
Ste 43
Dothan, AL 36305
Phone (334) 793-7211

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223510400000",
    "number": "1346490604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 W MAIN ST",
            "address_2": "SUITE 43",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051054",
            "telephone_number": "334-793-7211",
            "fax_number": "334-793-5425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W MAIN ST",
            "address_2": "SUITE 43",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051054",
            "telephone_number": "334-793-7211",
            "fax_number": "334-793-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEAGIN & OWEN, M.D.., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-23",
        "last_updated": "2008-10-09",
        "status": "A",
        "authorized_official_last_name": "BYRD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "INSURANCE",
        "authorized_official_telephone_number": "334-793-7211"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "AL",
            "license": "7921",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "AL",
            "license": "13944",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000011782",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000082133",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI FOR DR. CHARLES FEAGIN",
            "identifier": "1427141282",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI FOR DR. WILLIAM I. OWEN",
            "identifier": "1619062064",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA  PROVIDER NUMBER --  CHARLES FEAGIN, M.D.",
            "identifier": "11782",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA PROVIDER FOR DR. WILLIAM I. OWEN, JR",
            "identifier": "82133",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA MEDICAID PAYEE ID:  529001560",
            "identifier": "529001560",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.