Individual provider Active NPI

Brianna Owen

  • Women's Health Nurse Practitioner
  • New Bedford, MA
National Provider Identifier
1992489462
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
RN2357822 Issued in MA
Practice address
874 Purchase St
New Bedford, MA 02740-6232
Phone
(508) 992-6553
NPI assigned
Jun 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2357822 MA
Women's Health Nurse Practitioner 363LW0102X RN2357822 MA Primary

Addresses

Primary practice location

874 Purchase St
New Bedford, MA 02740-6232

Mailing address

874 Purchase St
New Bedford, MA 02740-6232

Other practice location 1

2600 Tamarack Ave Ste 200
South Windsor, CT 06074-5560
Phone (860) 646-1157

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240212001048 CT Practitioner - Nurse Practitioner 2860835477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OBGYN Group of Eastern Connecticut PCGroup PAC ID 2769370352, 12 clinicians

Practice addresses (Care Compare)

2600 Tamarack Ave
Suite 200
South Windsor, CT 06074-5560
Phone (860) 646-1157

Hospital & facility affiliations

  • Manchester Memorial Hospital Hospital, Manchester, CT, CCN 070027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2357822MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
OBGYN Group of Eastern Connecticut, P.C. CurrentSince Feb 1, 2024 Accepting new patients

Locations

622 Hebron Ave
Ste 104A
Glastonbury, CT 06033
Phone (860) 646-1157

2600 Tamarack Ave
#200
South Windsor, CT 06074
Phone (860) 646-1157

Interoperability endpoints

  • Direct secure messaging: brianna.owen.1@27673.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1992489462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 PURCHASE ST",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027406232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 PURCHASE ST",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027406232",
            "telephone_number": "508-992-6553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 Tamarack Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "South Windsor",
            "state": "CT",
            "postal_code": "060745560",
            "country_code": "US",
            "telephone_number": "860-646-1157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWEN",
        "first_name": "BRIANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2357822",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "RN2357822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bedford, MA

Sources for this page

Verify at the official NPI Registry.