Jason Allen, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Florence, SC
NPI 1063276152 · NPPES record last updated Feb 8, 2024
Key facts
- NPI
- 1063276152
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 2023209997 (SC)
- Practice address
- 2351 Chadwick Dr
Florence, SC 29501-6423 - Phone
- (843) 616-3399
- NPI assigned
- Feb 8, 2024
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 11
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Musc Community Physicians
Practice addresses (Care Compare)
1218 Roberts St
Camden, SC 29020-3736
Phone (803) 425-6460
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SC, OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251125004129 | SC | Practitioner - Nurse Practitioner | 3072005164 | Reassigns benefits to 1 organization |
| I20260119000388 | OR | Practitioner - Nurse Practitioner | 3072005164 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023209997 | SC | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifeline Medical Center | Single Specialty | Current |
Accepting new patients |
| Musc Community Physicians | Single Specialty | Current |
Accepting new patients |
| Musc Community Physicians | Current |
Accepting new patients |
Locations
1915 NE Stucki Ave
Ste 400
Hillsboro, OR 97006
Phone (844) 408-0014
506 North St
Bamberg, SC 29003
Phone (803) 245-6290
1218 Roberts St
Camden, SC 29020
Phone (803) 425-6460
Interoperability endpoints
- https://api.platform.athenahealth.com/20067/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | 2023209997 | SC | Yes |
Addresses
Primary practice location
2351 Chadwick Dr
Florence, SC 29501-6423
Mailing address
1826 Partridge Cir
Florence, SC 29505-3150
Phone (843) 616-3399
Other providers in Florence, SC
- Harry S. Allen II III
- Frances Michelle Allen Strickland
- Gaye Allen-Cook
- Dan H Allen
- Edwin M Allen
- Ruth Lanora Allen
- Tiffany Allen
- Allergy Asthma Sinus Ctr
- Allied Healthcare LLC
- Naynarium Alls
All providers in Florence, SC · Psychiatric/Mental Health Nurse Practitioner in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.