NPIMap

Individual provider Active NPI

Kenneth D. Owen Jr., MD

  • Cardiovascular Disease Physician
  • Charlotte, NC
National Provider Identifier
1922117191
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
34700 Issued in NC
Practice address
1900 Brunswick Ave
Charlotte, NC 28207-1822
Phone
(704) 302-8400
Fax
(704) 358-4451
NPI assigned
Aug 30, 2006
Last updated
Sep 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34700 NC
Cardiovascular Disease Physician 207RC0000X 34700 NC Primary

Addresses

Primary practice location

1900 Brunswick Ave
Charlotte, NC 28207-1822

Mailing address

PO Box 601643
Charlotte, NC 28260-1643
Phone (704) 335-4400

Other identifiers 3

IdentifierTypeStateIssuer
1922117191MedicaidNC
5905027MedicaidNC
N34700MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20061027000089 NC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3577560960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Wake Forest University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tryon Medical Partners, PLLCGroup PAC ID 7113277971, 139 clinicians

Practice addresses (Care Compare)

6060 Piedmont Row Dr S
Charlotte, NC 28287-2800
Phone (704) 495-6334

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tryon Medical Partners, PLLC Internal Medicine CurrentSince Sep 1, 2018 Accepting new patients
Tryon Endoscopy Center, LLC PastSince Oct 18, 2018 Accepting new patients

Locations

5950 Fairview Rd
Ste 330
Charlotte, NC 28210

6060 Piedmont Row Dr S
Charlotte, NC 28287
Phone (704) 552-0116

6060 Piedmont Row Dr S
Fl 10
Charlotte, NC 28287
Phone (704) 489-3094

6060 Piedmont Row Dr S
Fl 6
Charlotte, NC 28210

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17847/brand/1/csg/41/fhir/r4
  • Direct secure messaging: kenneth.owen.1@17847.direct.athenahealth.com

Organizations & group practices 2

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 8

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

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1922117191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601643",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601643",
            "telephone_number": "704-335-4400",
            "fax_number": "704-358-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 BRUNSWICK AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071822",
            "telephone_number": "704-302-8400",
            "fax_number": "704-358-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "KENNETH",
        "middle_name": "D.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "34700",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "34700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922117191",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905027",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N34700",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.