NPIMap

Organization Active NPI

M H Allen LLC

  • Optometrist
  • Flowood, MS
National Provider Identifier
1003055872
Registry record updated Jul 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
621 Issued in MS
Legal business name
M H ALLEN LLC
Practice address
4810 Lakeland Dr
Flowood, MS 39232-8694
Phone
(601) 939-6366
Fax
(601) 939-3482
NPI assigned
Feb 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2014

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

Authorized official

Name
Dr. Mark H Allen, ODNPI 1467551549
Title
Owner/Optometrist
Phone
(601) 939-6366

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 621 MS Primary
Eyewear Supplier 332H00000X 621 MS

Addresses

Primary practice location

4810 Lakeland Dr
Flowood, MS 39232-8694

Mailing address

PO Box 321443
Flowood, MS 39232-1443
Phone (601) 939-6366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930004243 MS DME Supplier - Physician - OptometristDME Supplier - Optician 4284833385 Practice locations: Flowood, MS
O20141105001154 MS Part B Supplier - Clinic/Group Practice 4284833385 Receives reassigned benefits from 2 practitioners
Practice locations: Flowood, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
M H Allen LLC4810 Lakeland Dr, Flowood, MS 39232-8694(601) 939-6366 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Dec 22, 2020

National Provider Directory

National Provider Directory

Locations

4810 Lakeland Dr
Flowood, MS 39232
Phone (601) 932-1115

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404345600000",
    "number": "1003055872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 321443",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392321443",
            "telephone_number": "601-939-6366",
            "fax_number": "601-939-3482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 LAKELAND DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328694",
            "telephone_number": "601-939-6366",
            "fax_number": "601-939-3482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M H ALLEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-18",
        "last_updated": "2014-07-03",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "601-939-6366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "621",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MS",
            "license": "621",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.