Matthew Shane Owens, M.A.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

6301011431 Issued in MI

Practice address

420 W 5TH Ave
Flint, MI 48503-2445

Phone

(248) 678-4749

NPI assigned

Feb 28, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Genesee Health System

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Flint, MI
  • NPI 1043554348

  Community/Behavioral Health

  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1497883979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19705 VINE DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480446518",
            "telephone_number": "248-678-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W 5TH AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032445",
            "telephone_number": "248-678-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "MATTHEW",
        "middle_name": "SHANE",
        "name_prefix": "Mr.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6361005054",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "6301011431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "386004868",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ali K Owda, MD
• Amy Owen, MPT
• Chakhari S Owens
• Eric Owens
• Linda Allison Owens
• Sandra Marie Owens
• Skylar Myree Owens
• Oxford Anesthesia Services PLLC
• Deborah S Oxford, CRNA
• Jessica Oza

• Community/Behavioral Health Agency in Flint, MI
• Providers in Flint, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.