Active NPI
Sylvia A Owen, MD
- Dermatology Physician
- Kalispell, MT
National Provider Identifier
1366500464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 10806
- Practice address
- 40 Four Mile Dr Ste 7
Kalispell, MT 59901-2655 - Phone
- (406) 314-6336
- Fax
- (406) 890-6711
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 10806 | MT | Primary |
Addresses
Primary practice location
40 Four Mile Dr Ste 7
Kalispell, MT 59901-2655
Mailing address
40 Four Mile Dr Ste 7
Kalispell, MT 59901-2655
Phone (406) 314-6336
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00143741 | Medicaid | MT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10806 | MT | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Highline Dermatology & Skin Cancer | Dermatology | Current | Accepting new patients |
Locations
40 Four Mile Dr
Ste 7
Kalispell, MT 59901
Phone (406) 314-4788
505 Cascade Loop
Kalispell, MT 59901
Phone (406) 314-4788
Organizations & group practices 2
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.
-
- Dermatology Physician
- Kalispell, MT
- NPI 1407366545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601251200000",
"number": "1366500464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 FOUR MILE DR STE 7",
"city": "KALISPELL",
"state": "MT",
"postal_code": "599012655",
"telephone_number": "406-314-6336",
"fax_number": "406-890-6711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 FOUR MILE DR STE 7",
"city": "KALISPELL",
"state": "MT",
"postal_code": "599012655",
"telephone_number": "406-314-6336",
"fax_number": "406-890-6711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OWEN",
"first_name": "SYLVIA",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2020-09-28",
"certification_date": "2020-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MT",
"license": "10806",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00143741",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kalispell, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.