Individual provider Active NPI

Elisabeth Anne Owen, CRNP

  • Adult Health Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1417589474
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1-123103 Issued in AL
Practice address
810 Franklin St SE Ste a
Huntsville, AL 35801-4310
Phone
(256) 533-7676
NPI assigned
Feb 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Registered Nurse 163WN0300X 1-123103 AL
Adult Health Nurse Practitioner 363LA2200X 1-123103 AL Primary

Addresses

Primary practice location

810 Franklin St SE Ste a
Huntsville, AL 35801-4310

Mailing address

1122 Indian Creek Rd NW
Huntsville, AL 35806-1108
Phone (256) 759-0182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20200320001660 AL Practitioner - Nurse Practitioner 8426486648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Huntsville Renal Clinic, PCGroup PAC ID 0749266237, 15 clinicians

Practice addresses (Care Compare)

810 Franklin St SE
Suite a
Huntsville, AL 35801-4310
Phone (256) 533-7676

810 Franklin St SE a
Huntsville, AL 35801-4310

Hospital & facility affiliations

  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039
  • Athens Limestone Hospital Hospital, Athens, AL, CCN 010079
  • Marshall Medical Centers Hospital, Boaz, AL, CCN 010005
  • Decatur Morgan Hospital - Decatur Campus Hospital, Decatur, AL, CCN 010085
  • Highlands Medical Center Hospital, Scottsboro, AL, CCN 010061

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Nephrologists Inc PastSince Feb 9, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: eowen24243@direct.acumenmd.com

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 5

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": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1417589474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 INDIAN CREEK RD NW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358061108",
            "telephone_number": "256-759-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 FRANKLIN ST SE STE A",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014310",
            "telephone_number": "256-533-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "ELISABETH",
        "middle_name": "ANNE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0300X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nephrology",
            "state": "AL",
            "license": "1-123103",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "1-123103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.