Owen Stanley, M.S., ATC, CSCS, EMT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2007008863 Issued in MO

Practice address

239 Champions Dr
Columbia, MO 65211-0001

Phone

(979) 862-6005

Fax

(979) 847-8514

NPI assigned

Dec 9, 2009

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Emergency Medical Technician, Master of Science

State licenses

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

{
    "created_epoch": "1260316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1992034631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MISSOURI ATHLETICS 239 CHAMPIONS DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652110001",
            "telephone_number": "573-239-8177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 CHAMPIONS DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652110001",
            "telephone_number": "979-862-6005",
            "fax_number": "979-847-8514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "OWEN",
        "name_prefix": "Mr.",
        "credential": "M.S., ATC, CSCS, EMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-09",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT6621",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SD",
            "license": "0328",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2007008863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHLETIC TRAINING",
            "identifier": "110202002",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "owenstanley@missouri.edu",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "Missouri Athletics 239 Champions Dr",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652110001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Glenwood Shelton Stancil Jr., NBC-HWC, RT(R)(CT)
• Derek Ross Staner, MD
• Rebekah Elizabeth Stanfast, LCSW
• Lisa Stankey, PT
• Alexander Thaddeus Stanley, DDS
• James Patrick Stannard, M.D.
• James Tadashi Stannard, MD, PHD
• Julie Anne Deles Stansfield, MD, FACP
• Brittney Noel Stanton
• Frances A Stapleton, APRN

• Athletic Trainer in Columbia, MO
• Providers in Columbia, MO by specialty
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.