Jerry Ellen Owensby, M.D., P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

23843 Issued in AZ

Legal business name

JERRY ELLEN OWENSBY, M.D., P.C.

Practice address

6242 E Arbor Ave
Suite 111
Mesa, AZ 85206-1309

Phone

(480) 610-8183

Fax

(480) 610-8566

NPI assigned

Jul 7, 2006

Last updated

Apr 18, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jerry Ellen Owensby, M.D.

Title

M.D.

Phone

(480) 610-8183

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1598797003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6242 E ARBOR AVE",
            "address_2": "SUITE 111",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061309",
            "telephone_number": "480-610-8183",
            "fax_number": "480-610-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6242 E ARBOR AVE",
            "address_2": "SUITE 111",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061309",
            "telephone_number": "480-610-8183",
            "fax_number": "480-610-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY ELLEN OWENSBY, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "OWENSBY",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "480-610-8183",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "23843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0838370",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1023413",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; 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.