Stanford Allen Owen, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

08597 Issued in MS

Practice address

3300 15TH St
Gulfport, MS 39501-3901

Phone

(228) 864-9669

Fax

(228) 864-9774

NPI assigned

Nov 29, 2005

Last updated

Sep 4, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Hancock Emergency Group LLC

  • Emergency Medicine Physician
  • Bay St Louis, MS
  • NPI 1295142396
  Medicare reassignment NPD
• Internal Medicine Clinic of Picayune

  dba The Center For Health Management

  • Internal Medicine Physician
  • Gulfport, MS
  • NPI 1528004322
  NPD (past) Authorized official
• Acs Emergency Services of Mississippi Professional Association

  • Emergency Medicine Physician
  • Cleveland, MS
  • NPI 1396996997
  NPD (past)
• Camellia Pharmacy Services LLC

  • Home Infusion Therapy Pharmacy
  • Flowood, MS
  • NPI 1861727588
  NPD (past)

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1972587418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 15TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395013901",
            "telephone_number": "228-864-9669",
            "fax_number": "228-864-9774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 15TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395013901",
            "telephone_number": "228-864-9669",
            "fax_number": "228-864-9774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "STANFORD",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "013830",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "08597",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "08597",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00017546",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110115663",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1198455",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110121961",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sally Ott
• Kent T Overmyer, M.D.
• Darla Ann Overstreet
• Aiden Overton
• Muhammad Owais
• Jillian Anne Owens, FNP-BC
• Michael Owens
• Elizabeth Ozene
• Robert K Ozon, MD
• Richard J Paddock, MD

• Internal Medicine Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.