NPIMap

Individual provider Active NPI

Allen Bley Reavis, DDS

  • General Practice Dentistry
  • Atchison, KS
National Provider Identifier
1013987627
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6084 Issued in KS
Practice address
111 N 5TH St
Atchison, KS 66002-0399
Phone
(913) 367-0212
Fax
(913) 367-6214
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6084 KS Primary
General Practice Dentistry 1223G0001X 14104 MO

Addresses

Primary practice location

111 N 5TH St
Atchison, KS 66002-0399

Mailing address

PO Box 399
111 N 5TH
Atchison, KS 66002-0399
Phone (913) 367-0212

Other identifiers 3

IdentifierTypeStateIssuer
10022285BMedicaidKS
116750OtherBCBS
9176546OtherKSDORAL MEDICAID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6084KSMDGeneral Practice Dentistry
14104MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Atchison Community Health Clinic, Inc. Past Accepting new patients
Atchison Community Health Clinic Inc Past Accepting new patients
Atchison Dental Associates 2 PA General Practice Past Accepting new patients
Atchison Dental Associates PA General Practice Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJICAD/Endpoint/CJICAD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1013987627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399",
            "address_2": "111 N 5TH",
            "city": "ATCHISON",
            "state": "KS",
            "postal_code": "660020399",
            "telephone_number": "913-367-0212",
            "fax_number": "913-367-6214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N 5TH ST",
            "city": "ATCHISON",
            "state": "KS",
            "postal_code": "660020399",
            "telephone_number": "913-367-0212",
            "fax_number": "913-367-6214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAVIS",
        "first_name": "ALLEN",
        "middle_name": "BLEY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "6084",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "14104",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10022285B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "116750",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL MEDICAID",
            "identifier": "9176546",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atchison, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.