Individual provider Active NPI

Hudson Jackson Owen Jr., P.A.-C

  • Physician Assistant
  • Dublin, GA
National Provider Identifier
1770548984
Registry record updated Jun 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
000148 Issued in GA
Practice address
206A Hospital Dr
Dublin, GA 31021-2989
Phone
(478) 272-3525
Fax
(478) 272-3504
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 000148 GA Primary

Addresses

Primary practice location

206A Hospital Dr
Dublin, GA 31021-2989

Mailing address

206 Hospital Dr Ste a
Dublin, GA 31021-2560
Phone (478) 272-3525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Cardiology Associates PC Current Accepting new patients
Dublin-Macon Cardiology, PC CurrentSince Jun 4, 2012 Accepting new patients
Sterling Emergency Services of the Southeast Inc Past Accepting new patients
Washington County Internal Medicine, P.C. Past Accepting new patients

Locations

200 Industrial Blvd
Dublin, GA 31021
Phone (478) 274-3865

206 Hospital Dr
Ste A
Dublin, GA 31021
Phone (478) 272-3525

Interoperability endpoints

  • Direct secure messaging: hudson.owen@cad.gadirect.net
  • Direct secure messaging: clinical@dmcardio.directbygreenway.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1770548984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 HOSPITAL DR STE A",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212560",
            "telephone_number": "478-272-3525",
            "fax_number": "478-272-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206A HOSPITAL DR",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212989",
            "telephone_number": "478-272-3525",
            "fax_number": "478-272-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "HUDSON",
        "middle_name": "JACKSON",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "000148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, GA

Sources for this page

Verify at the official NPI Registry.