Individual provider Active NPI

Linda Carol Owen, P.T.

  • Physical Therapist
  • Virginia Beach, VA
National Provider Identifier
1811040165
Registry record updated Feb 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305002340 Issued in VA
Practice address
5265 Providence Rd
Suite 503
Virginia Beach, VA 23464-4206
Phone
(757) 523-4705
Fax
(757) 523-4653
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305002340 VA Primary

Addresses

Primary practice location

5265 Providence Rd
Suite 503
Virginia Beach, VA 23464-4206

Mailing address

5265 Providence Rd
Suite 503
Virginia Beach, VA 23464-4206
Phone (757) 581-4892

Other identifiers 1

IdentifierTypeStateIssuer
239374OtherVABC BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090225000233 VA Practitioner - Physical Therapist in Private Practice 9830255926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5265 Providence Rd
Suite 503
Virginia Beach, VA 23464-4210
Phone (757) 523-4705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305002340VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kempsville Physical Therapy P C Physical Therapist CurrentSince Aug 2, 2001 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist Past Accepting new patients
Haygood Physical Therapy, PC Physical Therapist PastSince May 28, 2014 Accepting new patients

Locations

5265 Providence Rd
Ste 503
Virginia Beach, VA 23464
Phone (757) 523-1111

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1811040165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5265 PROVIDENCE RD",
            "address_2": "SUITE 503",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644206",
            "telephone_number": "757-581-4892",
            "fax_number": "757-523-4653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5265 PROVIDENCE RD",
            "address_2": "SUITE 503",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644206",
            "telephone_number": "757-523-4705",
            "fax_number": "757-523-4653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "LINDA",
        "middle_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305002340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "239374",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; 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.