Active NPI
Roger A Owen, MD
- Pediatrics Physician
- Springfield, VT
National Provider Identifier
1518981182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 042-0005683
- Practice address
- 29 Ridgewood Rd
The Pediatric Network
Springfield, VT 05156-3050 - Phone
- (802) 885-5716
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 042-0005683 | VT | Primary |
Addresses
Primary practice location
29 Ridgewood Rd
The Pediatric Network
Springfield, VT 05156-3050
Mailing address
PO Box 2003
The Pediatric Network
Springfield, VT 05156-2003
Phone (802) 885-5716
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0004629 | Medicaid | VT | |
| 30009000 | Medicaid | NH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042-0005683 | VT | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1518981182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2003",
"address_2": "THE PEDIATRIC NETWORK",
"city": "SPRINGFIELD",
"state": "VT",
"postal_code": "051562003",
"telephone_number": "802-885-5716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 RIDGEWOOD RD",
"address_2": "THE PEDIATRIC NETWORK",
"city": "SPRINGFIELD",
"state": "VT",
"postal_code": "051563050",
"telephone_number": "802-885-5716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OWEN",
"first_name": "ROGER",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VT",
"license": "042-0005683",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0004629",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30009000",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, VT
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.