Owen B. Tabor Sr., M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

6996 Issued in TN

Practice address

1244 Primacy Pkwy
Memphis, TN 38119-0201

Phone

(901) 767-8662

Fax

(901) 259-2785

NPI assigned

Feb 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• MSK Group, PC

  • Orthopaedic Surgery Physician
  • Memphis, TN
  • NPI 1376541409
  NPD (past)
• Tabor Orthopedics, P.C.

  • Specialist
  • Memphis, TN
  • NPI 1750356705
  NPD (past)
• MSK Group PC

  • Orthopaedic Surgery Physician
  • Southaven, MS
  • NPI 1912303447
  NPD (past)
• MSK Group, PC

  • Physical Therapist
  • Southaven, MS
  • NPI 1114793189

  Orthopaedic Surgery

  NPD (past)

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1942275896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8888",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049158888",
            "telephone_number": "901-259-4260",
            "fax_number": "901-259-2785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 PRIMACY PKWY",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190201",
            "telephone_number": "901-767-8662",
            "fax_number": "901-259-2785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABOR",
        "first_name": "OWEN",
        "middle_name": "B.",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "6996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07187860",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3179854",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3371161",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4179726",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4442032",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120469",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "620819926",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00624370",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "00000207490 08",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4039349",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "620819926",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lakesha A Tables, MD
• Tabor Orthopedics, P.C.
• Camille Barnell Tabor-Cobb, DDS
• Jennifer Sloan Tabor, LCSW
• Owen B. Tabor Jr., M.D.
• Charlie Andrew Tacito
• Deanna Rae Tacker, MS, RD, LDN
• Herman L Tacker, O.D.
• Timothy Paul Tackett Jr., M.D.
• Sarah Taddia

• Orthopaedic Surgery Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Orthopaedic Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.