Individual provider Active NPI

Michael Patrick Gowen Sr., OD

  • Optometrist
  • Harrisonburg, VA
National Provider Identifier
1831170026
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000690 Issued in VA
Practice address
1870 Reservoir St
Harrisonburg, VA 22801-8742
Phone
(540) 434-6622
Fax
(540) 434-4187
NPI assigned
Nov 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000690 VA Primary

Addresses

Primary practice location

1870 Reservoir St
Harrisonburg, VA 22801-8742

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other practice location 1

1870 Reservoir St
Harrisonburg, VA 22801-8742
Phone (540) 434-6622

Other identifiers 1

IdentifierTypeStateIssuer
1831170026MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101021001106 VA Practitioner - Optometry 1951475649 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618000690VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Apr 12, 2016 Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Apr 12, 2016 Accepting new patients
Myeyedr Optometry of Virginia PLLC Optometrist Current Accepting new patients
Gowen Eye, LLC Optometrist CurrentSince Oct 22, 2012 Accepting new patients

Locations

44727 Brimfield Dr
Ashburn, VA 20147
Phone (571) 385-4600

620 N Main St
Ste 101
Blacksburg, VA 24060
Phone (540) 953-0136

1870 Reservoir St
Harrisonburg, VA 22801
Phone (540) 434-6622

1412 N Augusta St
Staunton, VA 24401
Phone (540) 885-0006

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

251 W Lee Hwy
Ste 632
Warrenton, VA 20186
Phone (540) 428-3937

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1831170026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "866-795-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 RESERVOIR ST",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228018742",
            "telephone_number": "540-434-6622",
            "fax_number": "540-434-4187"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1870 Reservoir St",
            "address_purpose": "LOCATION",
            "city": "Harrisonburg",
            "state": "VA",
            "postal_code": "228018742",
            "country_code": "US",
            "telephone_number": "540-434-6622",
            "fax_number": "540-434-4187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOWEN",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831170026",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisonburg, VA

Sources for this page

Verify at the official NPI Registry.