Individual provider Active NPI

Samie Jo Owens

  • Family Nurse Practitioner
  • Troy, MO
National Provider Identifier
1376384040
Registry record updated Aug 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2024032570 Issued in MO
Practice address
1003 E Cherry St
Troy, MO 63379-1503
Phone
(636) 528-6755
NPI assigned
Jun 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2021024140 MO
Family Nurse Practitioner 363LF0000X 2024032570 MO Primary

Addresses

Primary practice location

1003 E Cherry St
Troy, MO 63379-1503

Mailing address

1003 E Cherry St
Troy, MO 63379-1503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20241009000888 MO Practitioner - Nurse Practitioner 1658802079 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
Mercy Hospital LincolnGroup PAC ID 5193040020, 31 clinicians

Practice addresses (Care Compare)

1003 E Cherry St
Troy, MO 63379-1503
Phone (636) 528-6755

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021024140MOMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Lincoln CurrentSince Sep 16, 2024 Accepting new patients
Mercy Hospital Lincoln CurrentSince Sep 16, 2024 Accepting new patients

Locations

1003 E Cherry St
Troy, MO 63379
Phone (636) 528-6755

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723939200000",
    "number": "1376384040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791503",
            "telephone_number": "636-528-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "SAMIE",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-08-18",
        "certification_date": "2024-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2021024140",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2024032570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MO

Sources for this page

Verify at the official NPI Registry.