Individual provider Active NPI

Allison Drew Dezarn, APRN

  • Nurse Practitioner
  • Hazard, KY
National Provider Identifier
1083066591
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3010409 Issued in KY
Practice address
210 Black Gold Blvd
Hazard, KY 41701-2620
Phone
(606) 436-0711
Fax
(606) 436-0519
NPI assigned
Jul 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 3010409 KY
Nurse Practitioner 363L00000X 3010409 KY Primary

Addresses

Primary practice location

210 Black Gold Blvd
Hazard, KY 41701-2620

Mailing address

279 E Main St
Hazard, KY 41701-1973
Phone (606) 487-9505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20160804002646 KY Practitioner - Nurse Practitioner 8527352186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentucky Mountain Health Alliance, Inc.Group PAC ID 8123112687, 20 clinicians

Practice addresses (Care Compare)

210 Black Gold Blvd
Suite 106
Hazard, KY 41701-2620
Phone (606) 436-0711

279 E Main St
Hazard, KY 41701-1973
Phone 6064879505309

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3010409KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Mountain Health Alliance, Inc. Federally Qualified Health Center (FQHC) CurrentSince Oct 2, 2017 Accepting new patients
Jackson Hospital Corporation Nurse Practitioner Past Accepting new patients

Locations

210 Black Gold Blvd
Ste 106
Hazard, KY 41701
Phone (606) 436-0711

210 Black Gold Blvd
Hazard, KY 41701
Phone (606) 436-0711

279 E Main St
Ste 100
Hazard, KY 41701

390 Park Ave
Hazard, KY 41701
Phone (606) 439-2306

279 E Main St
Hazard, KY 41701
Phone (606) 487-9505

100 Medical Dr
Hazard, KY 41701
Phone (606) 439-6600

Interoperability endpoints

  • Direct secure messaging: allyson.dezarn.p1@direct.kymha.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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 2

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": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1083066591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 E MAIN ST",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417011973",
            "telephone_number": "606-487-9505",
            "fax_number": "606-436-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 BLACK GOLD BLVD",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417012620",
            "telephone_number": "606-436-0711",
            "fax_number": "606-436-0519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEZARN",
        "first_name": "ALLISON",
        "middle_name": "DREW",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-08",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "KY",
            "license": "3010409",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3010409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazard, KY

Sources for this page

Verify at the official NPI Registry.