Individual provider Active NPI

Eudora R. Owoso

  • Physical Therapist
  • Marion, AR
National Provider Identifier
1376664581
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT1730 Issued in OK
Practice address
None Currently
Marion, AR 72364-1296
Phone
(770) 289-2881
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT1730 OK Primary

Addresses

Primary practice location

None Currently
Marion, AR 72364-1296

Mailing address

PO Box 1296
Marion, AR 72364-1296
Phone (770) 289-2881

Other identifiers 1

IdentifierTypeStateIssuer
PT1730OtherOKLICENSCE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT1730OKMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376664581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1296",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723641296",
            "telephone_number": "770-289-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NONE CURRENTLY",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723641296",
            "telephone_number": "770-289-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWOSO",
        "first_name": "EUDORA",
        "middle_name": "R.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "PT1730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSCE NUMBER",
            "identifier": "PT1730",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.