Johnnie Mae Owens, CNA CHILD CARE CREDE

Primary specialty

Orthotic FitterTaxonomy code 225000000X

Practice address

801 E Northside Dr
Suite D
Clinton, MS 39056-3663

Phone

(601) 906-1024

NPI assigned

May 27, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Johnnie Mae Irby Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Custom Prosthetic & Orthotic

  • Prosthetic/Orthotic Supplier
  • Clinton, MS
  • NPI 1710147301
  NPD (past) Authorized official

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311206400000",
    "number": "1740448802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E NORTHSIDE DR",
            "address_2": "SUITE D",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390563663",
            "telephone_number": "601-906-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E NORTHSIDE DR",
            "address_2": "SUITE D",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390563663",
            "telephone_number": "601-906-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "JOHNNIE",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "credential": "CNA CHILD CARE CREDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-27",
        "last_updated": "2011-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHNNIE",
            "last_name": "IRBY",
            "middle_name": "MAE",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Austine Onyia
• Optical 2000
• Orme Medical PLLC
• Woody L. Osborn, D.M.D.
• Stephanie Nicole Owen
• Tonia Rene Owens
• Jada Palmer
• Jakayla Palmer
• Palmetto Senior Care
• Walter Pang, O.D.

• Orthotic Fitter in Clinton, MS
• Providers in Clinton, MS by specialty
• Orthotic Fitter in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; 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.