Individual provider Active NPI

Susan Bignall Owensby, M.D.

  • Pediatrics Physician
  • Belmont, NC
National Provider Identifier
1972590685
Registry record updated Jul 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
9601426 Issued in NC
Practice address
209 Park St
Suite 500
Belmont, NC 28012-5205
Phone
(704) 829-0025
Fax
(704) 829-0031
NPI assigned
Sep 29, 2005
Last updated
Jul 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 9601426 NC Primary

Addresses

Primary practice location

209 Park St
Suite 500
Belmont, NC 28012-5205

Mailing address

209 Park St
Suite 500
Belmont, NC 28012-5205
Phone (704) 829-0025

Other identifiers 2

IdentifierTypeStateIssuer
891157AMedicaidNC
N01426MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20110422000360 NC Practitioner - Pediatric Medicine 6305021023 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc Pediatrics Current Accepting new patients
Caromont Medical Group Inc CurrentSince Mar 22, 2011 Accepting new patients
Caromont Medical Group Inc CurrentSince Mar 22, 2011 Accepting new patients

Locations

1212 Spruce St
Ste 201
Belmont, NC 28012
Phone (704) 825-3455

209 Park St
Ste 500
Belmont, NC 28012
Phone (704) 829-0025

2240 Remount Rd
Gastonia, NC 28054
Phone (704) 671-5311

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310083200000",
    "number": "1972590685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 PARK ST",
            "address_2": "SUITE 500",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "280125205",
            "telephone_number": "704-829-0025",
            "fax_number": "704-829-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 PARK ST",
            "address_2": "SUITE 500",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "280125205",
            "telephone_number": "704-829-0025",
            "fax_number": "704-829-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENSBY",
        "first_name": "SUSAN",
        "middle_name": "BIGNALL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2011-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9601426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891157A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N01426",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, NC

Sources for this page

Verify at the official NPI Registry.