Individual provider Active NPI

Dena Shae Owens, PTA

  • Physical Therapy Assistant
  • Brandon, MS
National Provider Identifier
1497056915
Registry record updated May 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA 2698 Issued in MS
Practice address
6100 Old Brandon Rd
Brandon, MS 39042-2543
Phone
(601) 260-4605
Fax
(601) 933-1113
NPI assigned
Nov 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA 2698 MS Primary

Addresses

Primary practice location

6100 Old Brandon Rd
Brandon, MS 39042-2543

Mailing address

6100 Old Brandon Rd
Brandon, MS 39042-2543
Phone (601) 260-4605

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
PTA 2698MSMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304380800000",
    "number": "1497056915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 OLD BRANDON RD",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422543",
            "telephone_number": "601-260-4605",
            "fax_number": "601-933-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 OLD BRANDON RD",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422543",
            "telephone_number": "601-260-4605",
            "fax_number": "601-933-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "DENA",
        "middle_name": "SHAE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-15",
        "last_updated": "2011-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MS",
            "license": "PTA 2698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; 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.