NPIMap

Individual provider Active NPI

Damian Allen, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Jonesboro, AR
National Provider Identifier
1104358159
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
311 E Matthews Ave
Jonesboro, AR 72401-3125
Phone
(870) 972-0063
NPI assigned
Mar 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

311 E Matthews Ave
Jonesboro, AR 72401-3125

Mailing address

311 E Matthews Ave
Jonesboro, AR 72401-3125
Phone (870) 972-0063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190102001529 AR Practitioner - Family Practice 2062782808 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Bernards Hospital Inc. 187 clinicians
Five Rivers Medical Center Inc 37 clinicians

Practice addresses (Care Compare)

225 E Washington Ave
St Bernards Medical Center
Jonesboro, AR 72401-3119
Phone (870) 972-4100

2801 Medical Ctr Dr
Pocahontas, AR 72455-9436
Phone 87089260006200

Hospital & facility affiliations

  • St Bernards Medical Center Hospital, Jonesboro, AR, CCN 040020
  • Piggott Community Hospital Hospital, Piggott, AR, CCN 041330
  • St Bernards Five Rivers Medical Center Hospital, Pocahontas, AR, CCN 040779

Merit-based Incentive Payment System (MIPS)

Final score
57.32 of 100Reported as individual
Quality
30
Improvement activities
40
Cost
52.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Five Rivers Medical Center CurrentSince Nov 2, 2018 Accepting new patients
Five Rivers Medical Center Inc. CurrentSince Nov 2, 2018 Accepting new patients
St Bernards Hospital Inc Past Accepting new patients

Locations

2801 Medical Center Dr
Pocahontas, AR 72455
Phone (870) 892-6000

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 3

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": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1104358159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 E MATTHEWS AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013125",
            "telephone_number": "870-972-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 E MATTHEWS AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013125",
            "telephone_number": "870-972-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "DAMIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-29",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.