Individual provider Active NPI

Illa Jane Owens

  • Family Nurse Practitioner
  • Winchester, VA
National Provider Identifier
1932072675
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
24195093 Issued in VA
Practice address
480 W Jubal Early Dr Ste 200
Winchester, VA 22601-6448
Phone
(540) 313-6563
NPI assigned
Sep 29, 2025
Last updated
Dec 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 24195093 VA Primary

Addresses

Primary practice location

480 W Jubal Early Dr Ste 200
Winchester, VA 22601-6448

Mailing address

480 W Jubal Early Dr Ste 200
Winchester, VA 22601-6448
Phone (540) 313-6563

Other practice location 1

1004 Sushruta Dr Ste A
Martinsburg, WV 25401-8801
Phone (304) 449-3778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WV2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20260217003001 VA Practitioner - Nurse Practitioner 0840770954 Reassigns benefits to 1 organization
I20260220000357 WV Practitioner - Nurse Practitioner 0840770954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Marymount University, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kidney Specialists, PLLCGroup PAC ID 4284801796, 5 clinicians

Practice addresses (Care Compare)

1004 Sushruta Dr
Suite a
Martinsburg, WV 25401-8801
Phone (304) 449-3778

480 W Jubal Early Dr
Suite 200
Winchester, VA 22601-6448
Phone (540) 313-6563

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24195093VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Specialists, PLLC CurrentSince Dec 1, 2025 Accepting new patients
Talis Healthcare LLC PastSince Oct 5, 2025 Accepting new patients

Locations

1870 Amherst St
#2A
Winchester, VA 22601
Phone (540) 313-6563

480 W Jubal Early Dr
Ste 200
Winchester, VA 22601
Phone (540) 313-6563

1004 Sushruta Dr
Ste A
Martinsburg, WV 25401
Phone (304) 263-9418

176 Health Care Ln
Ste A
Martinsburg, WV 25401
Phone (304) 262-0085

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 5

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": "1759104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1932072675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 W JUBAL EARLY DR STE 200",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226016448",
            "telephone_number": "540-313-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 W JUBAL EARLY DR STE 200",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226016448",
            "telephone_number": "540-313-6563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1004 Sushruta Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Martinsburg",
            "state": "WV",
            "postal_code": "254018801",
            "country_code": "US",
            "telephone_number": "304-449-3778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWENS",
        "first_name": "ILLA",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-29",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "24195093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.