Individual provider Active NPI

Kimberly Ann Owens, APRN

  • Family Nurse Practitioner
  • Munfordville, KY
National Provider Identifier
1568640993
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3005297 Issued in KY
Practice address
950 Main St
Munfordville, KY 42765
Phone
(270) 524-1201
Fax
(270) 506-5972
NPI assigned
Feb 7, 2008
Last updated
Feb 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3005297 KY Primary

Addresses

Primary practice location

950 Main St
Munfordville, KY 42765

Mailing address

201 Park St
Bowling Green, KY 42101-1742
Phone (270) 524-1201

Other practice location 1

615 7th Ave
Bowling Green, KY 42101-6921
Phone (270) 783-3573 ext. 1034

Other identifiers 1

IdentifierTypeStateIssuer
7100158270MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20110225000777 KY Practitioner - Nurse Practitioner 1355522194 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3005297KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Logan Physician Practice LLC CurrentSince Apr 23, 2020 Accepting new patients
Logan Physician Practice, LLC Current Accepting new patients
Logan Physician Practice LLC CurrentSince Apr 23, 2020 Accepting new patients

Locations

128 Sugar Maple Dr
Auburn, KY 42206
Phone (270) 344-5157

975 Hopkinsville Rd
Russellville, KY 42276
Phone (270) 725-8350

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1568640993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011742",
            "telephone_number": "270-524-1201",
            "fax_number": "270-506-5972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 MAIN ST",
            "city": "MUNFORDVILLE",
            "state": "KY",
            "postal_code": "42765",
            "telephone_number": "270-524-1201",
            "fax_number": "270-506-5972"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 7th Ave",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "KY",
            "postal_code": "421016921",
            "country_code": "US",
            "telephone_number": "270-783-3573 x1034",
            "fax_number": "270-467-0225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWENS",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-07",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3005297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100158270",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munfordville, KY

Sources for this page

Verify at the official NPI Registry.