NPIMap

Individual provider Active NPI

Mary June Owen, MD

  • Family Medicine Physician
  • Cloquet, MN
National Provider Identifier
1801947320
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
44589 Issued in MN
Practice address
927 Trettel LN
Cloquet, MN 55720-1345
Phone
(218) 879-1227
NPI assigned
Jan 12, 2007
Last updated
Nov 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5223 AK
Family Medicine Physician 207Q00000X 44589 MN Primary

Addresses

Primary practice location

927 Trettel LN
Cloquet, MN 55720-1345

Mailing address

3245 Hospital Dr
Juneau, AK 99801-7809
Phone (907) 463-4040

Other practice location 1

3245 Hospital Dr
Juneau, AK 99801-7809
Phone (907) 463-4040

Other identifiers 1

IdentifierTypeStateIssuer
MD5745MedicaidAK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191204003137 MN Practitioner - Family Practice 5597667113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2000
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

927 Trettel LN
Cloquet, MN 55720-1345
Phone (218) 879-1227

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.26 of 100Reported as group
Quality
80.41
Promoting interoperability
80
Improvement activities
40
Cost
53.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5223AKMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Fond Du Lac Reservation Business Committee CurrentSince Dec 1, 2019 Accepting new patients
Fond Du Lac Reservation Business Committee CurrentSince Dec 1, 2019 Accepting new patients
University of Minnesota Physicians Past Accepting new patients

Locations

927 Trettel Ln
Cloquet, MN 55720
Phone (218) 879-1227

221 W 4th St
Duluth, MN 55806
Phone (218) 279-4142

Interoperability endpoints

  • Direct secure messaging: mary.owen.p1@direct.fonddulachsd.nextgenshare.com

Organizations & group practices 3

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 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1801947320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HOSPITAL DR",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017809",
            "telephone_number": "907-463-4040",
            "fax_number": "907-463-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 TRETTEL LN",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201345",
            "telephone_number": "218-879-1227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3245 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Juneau",
            "state": "AK",
            "postal_code": "998017809",
            "country_code": "US",
            "telephone_number": "907-463-4040",
            "fax_number": "907-463-5868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWEN",
        "first_name": "MARY",
        "middle_name": "JUNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "5223",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "44589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD5745",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cloquet, MN

Sources for this page

Verify at the official NPI Registry.