NPIMap

Organization Active NPI

J. Rena Owsley-Brown

  • General Practice Dentistry
  • Fayetteville, GA
National Provider Identifier
1801068754
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DNO12893 Issued in GA
Legal business name
J. RENA OWSLEY-BROWN
Practice address
1275 Highway 54 W
Suite 204
Fayetteville, GA 30214-4549
Phone
(770) 461-5500
Fax
(770) 461-1033
NPI assigned
Apr 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Authorized official

Name
J. Rena Owsley-Brown, DMDNPI 1144254004
Title
Dentist/Owner
Phone
(770) 461-5500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DNO12893 GA Primary

Addresses

Primary practice location

1275 Highway 54 W
Suite 204
Fayetteville, GA 30214-4549

Mailing address

1275 Highway 54 W
Suite 204
Fayetteville, GA 30214-4549
Phone (770) 461-5500

Other identifiers 1

IdentifierTypeStateIssuer
110289OtherGADORAL

National Provider Directory

National Provider Directory

Locations

1275 Highway 54 W
Ste 204
Fayetteville, GA 30214
Phone (770) 461-5500

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1801068754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 HIGHWAY 54 W",
            "address_2": "SUITE 204",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144549",
            "telephone_number": "770-461-5500",
            "fax_number": "770-461-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 HIGHWAY 54 W",
            "address_2": "SUITE 204",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144549",
            "telephone_number": "770-461-5500",
            "fax_number": "770-461-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. RENA OWSLEY-BROWN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "OWSLEY-BROWN",
        "authorized_official_first_name": "J.",
        "authorized_official_middle_name": "RENA",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "770-461-5500",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DNO12893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "110289",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.