Individual provider Active NPI

Charles Kevin Owens, PT

  • Physical Therapist
  • Shepherdsville, KY
National Provider Identifier
1629010889
Registry record updated Apr 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
004421 Issued in KY
Practice address
115 Huston Dr
Suite 3
Shepherdsville, KY 40165-7250
Phone
(502) 921-0272
Fax
(502) 921-0465
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 004421 KY Primary

Addresses

Primary practice location

115 Huston Dr
Suite 3
Shepherdsville, KY 40165-7250

Mailing address

10504 Firview CT
Louisville, KY 40299-5843
Phone (502) 741-6897

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110215000212 KY Practitioner - Physical Therapist in Private Practice 6709066384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SN Kentuckiana Rehab, LLCGroup PAC ID 1254671464, 339 clinicians

Practice addresses (Care Compare)

4420 Dixie Hwy
Suite 122
Louisville, KY 40216-2986
Phone (502) 447-2750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
SN Kentuckiana Rehab, LLC CurrentSince Apr 1, 2019 Accepting new patients
SN Kentuckiana Rehab, LLC Physical Therapist Current Accepting new patients
SN Kentuckiana Rehab, LLC CurrentSince Apr 1, 2019 Accepting new patients

Locations

10631 Dixie Hwy
Louisville, KY 40272
Phone (502) 447-2750

210 E Gray St
Ste 807
Louisville, KY 40202
Phone (502) 587-9350

2152 S Hurstbourne Pkwy
Louisville, KY 40220
Phone (502) 349-6961

115 Huston Dr
Ste 3
Shepherdsville, KY 40165
Phone (502) 629-2030

4420 Dixie Hwy
Ste 122
Shively, KY 40216
Phone (502) 447-2750

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302739200000",
    "number": "1629010889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10504 FIRVIEW CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402995843",
            "telephone_number": "502-741-6897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 HUSTON DR",
            "address_2": "SUITE 3",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401657250",
            "telephone_number": "502-921-0272",
            "fax_number": "502-921-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "CHARLES",
        "middle_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2011-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "004421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shepherdsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.