Staci Owen, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2948 Issued in TN

Practice address

701 Morganton Square Dr
Maryville, TN 37801-4796

Phone

(865) 984-6823

Fax

(865) 984-0824

NPI assigned

Jan 12, 2016

Last updated

Dec 11, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Blount Memorial Hospital Hospital, Maryville, TN, CCN 440011
• University Health System, Inc Hospital, Knoxville, TN, CCN 440015
• Parkwest Medical Center Hospital, Knoxville, TN, CCN 440173

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: staci.owen.2@20785.direct.athenahealth.com

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.

• Summit Medical Group, PLLC

  dba Cool Springs Internal Medicine and Pediatrics

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1659090298
  Medicare reassignment Care Compare group NPD
• Summit Medical Group, PLLC

  dba Rockwood Medical Associates

  • Internal Medicine Physician
  • Rockwood, TN
  • NPI 1568772754
  NPD
• Summit Medical Group PLLC

  dba Summit Medical Group of Oak Ridge

  • Family Medicine Physician
  • Oak Ridge, TN
  • NPI 1437238797
  NPD (past)
• Summit Medical Group, PLLC

  dba Maryville Family Medicine

  • Internal Medicine Physician
  • Maryville, TN
  • NPI 1255572574
  NPD (past)
• Summit Medical Group, PLLC

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1699722470
  NPD (past)
• Summit Medical Group,PLLC

  dba Summit Medical Group of Cookeville

  • Internal Medicine Physician
  • Cookeville, TN
  • NPI 1588362164
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Parkwest Medical Center

  dba Peninsula Div Parkwest MC

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1396739165
  Care Compare affiliation
• Prisma Health - Blount Memorial Hospital Inc.

  dba Blount Memorial Hospital

  • General Acute Care Hospital
  • Maryville, TN
  • NPI 1619939071
  Care Compare affiliation
• University Health System, Inc.

  dba University of Tennessee Medical Center

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1538164090
  Care Compare affiliation

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

{
    "created_epoch": "1452556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1477919074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E WEISGARBER RD",
            "address_2": "SUITE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092604",
            "telephone_number": "865-584-4747",
            "fax_number": "865-584-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MORGANTON SQUARE DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014796",
            "telephone_number": "865-984-6823",
            "fax_number": "865-984-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "STACI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-12",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "2948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisheva Ostrar, CCC-SLP
• Otolaryngology Center of East Tennessee PC
• Madison Overbay
• Shara Beth Overbay, LCSW
• Matthew Owen, CRNA
• Owens Orthodontic Specialists, PC
• Mark Joseph Owens Sr., DDS, MS
• Kelly Noel Ownby, M.D.
• Stephen E Pacifico, MD
• Lauren Ashley Pack, LCSW

• Physician Assistant in Maryville, TN
• Providers in Maryville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.