Individual provider Active NPI

Jordan Michael Owens, M.D.

  • Family Medicine Physician
  • Tyler, TX
National Provider Identifier
1659613990
Registry record updated Feb 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R8450 Issued in TX
Practice address
520 Douglas Blvd
Tyler, TX 75702
Phone
(903) 606-1721
NPI assigned
Mar 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R8450 TX Primary

Addresses

Primary practice location

520 Douglas Blvd
Tyler, TX 75702

Mailing address

PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6400

Other identifiers 8

IdentifierTypeStateIssuer
388263103MedicaidTX
BP20053157OtherTXTEXAS IN TRAINING PERMIT
388263102MedicaidTX
693470OtherTXMEDICARE
8KE616OtherTXBCBS
728055OtherTXMEDICARE
8JX687OtherTXBCBS
P02137083OtherTXMEDICARE RAIL ROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180821001853 TX Practitioner - Family Practice 5395094544 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

800 E Dawson St
Christus Trinity Clinic
Tyler, TX 75701-2036
Phone (903) 510-1186

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Tyler, TX, CCN 459457
  • Christus Homecare Home health agency, Tyler, TX, CCN 743197
  • Choice Homecare Home health agency, Tyler, TX, CCN 458261
  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
  • Christus Mother Frances Hospital- Jacksonville Hospital, Jacksonville, TX, CCN 451319
  • Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R8450TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mother Frances Hospital Jacksonville CurrentSince Mar 1, 2020 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Aug 6, 2018 Accepting new patients
Christus Trinity Clinic Texas Family Medicine CurrentSince Aug 6, 2018 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Sep 10, 2018 Accepting new patients

Locations

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

8288 S Broadway Ave
Tyler, TX 75703
Phone (903) 531-5433

5414 S Broadway Ave
Tyler, TX 75703
Phone (903) 581-1601

520 Douglas Blvd
Tyler, TX 75702
Phone (903) 510-1175

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

Interoperability endpoints

  • Direct secure messaging: jowens161673@christushealth.direct-ci.net

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550448000000",
    "number": "1659613990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 DOUGLAS BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75702",
            "telephone_number": "903-606-1721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "JORDAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-25",
        "last_updated": "2019-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R8450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "388263103",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS IN TRAINING PERMIT",
            "identifier": "BP20053157",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "388263102",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "693470",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8KE616",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "728055",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8JX687",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "P02137083",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.