Individual provider Active NPI

Matthew Owen, CRNA

  • Certified Registered Nurse Anesthetist
  • Maryville, TN
National Provider Identifier
1710763107
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
34803 Issued in TN
Practice address
907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015
Phone
(865) 977-5760
Fax
(865) 977-4788
NPI assigned
Sep 1, 2023
Last updated
Oct 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 34803 TN Primary

Addresses

Primary practice location

907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015

Mailing address

907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015
Phone (804) 350-1039

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231207002968 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335598937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blount Memorial Physician Group IncGroup PAC ID 6406844174, 252 clinicians

Practice addresses (Care Compare)

907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015
Phone (865) 980-4897

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.77 of 100Reported as group
Quality
58.61
Promoting interoperability
92
Improvement activities
40
Cost
73.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34803TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Blount Memorial Physician Group, Inc CurrentSince Nov 1, 2023 Accepting new patients

Locations

463 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 980-5100

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1693526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1710763107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 E LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045015",
            "telephone_number": "804-350-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 E LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045015",
            "telephone_number": "865-977-5760",
            "fax_number": "865-977-4788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-01",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "34803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.