Individual provider Active NPI

Michael Gary Allison, D.O.

  • Anesthesiology Physician
  • Crossville, TN
National Provider Identifier
1104814797
Registry record updated Jan 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
188099 Issued in PA
Practice address
421 South Main Street
Crossville, TN 38555
Phone
(931) 484-9511
Fax
(931) 456-4405
NPI assigned
Oct 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2012

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X OS-006810L PA
Pain Medicine (Anesthesiology) Physician 207LP2900X 18895 MS
Pain Medicine (Anesthesiology) Physician 207LP2900X 188099 NY
Pain Medicine (Anesthesiology) Physician 207LP2900X 6347 OH
Pain Medicine (Anesthesiology) Physician 207LP2900X 1974 TN
Anesthesiology Physician 207L00000X 188099 PA Primary

Addresses

Primary practice location

421 South Main Street
Crossville, TN 38555

Mailing address

1307 West Ave
Suite 102
Crossville, TN 38555-5107
Phone (931) 456-4433

Other identifiers 2

IdentifierTypeStateIssuer
01715897MedicaidNY
0016134270002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
188099PAMDAnesthesiology Physician
18895MSMDPain Medicine (Anesthesiology) Physician
6347OHMDPain Medicine (Anesthesiology) Physician
OS-006810LPAMDPain Medicine (Anesthesiology) Physician
39929SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concordia Anesthesiology, Inc Anesthesiology CurrentSince Apr 10, 2017 Accepting new patients
Northside Cherokee Anesthesia Associates Anesthesiology Past Accepting new patients
Apollomd Group Services, LLC Anesthesiology Past Accepting new patients
Wendy L Smith M.D. PC Past Accepting new patients
Newnan Anesthesia Associates, LLC Anesthesiology Past Accepting new patients
Deercreek Anesthesia Consultants PLLC Anesthesiology Past Accepting new patients
Lehigh Anesthesia Associates, P.C. Anesthesiology Past Accepting new patients

Locations

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

60 Hospital Rd
Newnan, GA 30263
Phone (770) 253-1912

11650 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 543-8132

391 Serpentine Dr
Ste 200
Spartanburg, SC 29303
Phone (864) 583-6381

Organizations & group practices 7

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": "1128816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1104814797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 WEST AVE",
            "address_2": "SUITE 102",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385555107",
            "telephone_number": "931-456-4433",
            "fax_number": "931-456-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 SOUTH MAIN STREET",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "38555",
            "telephone_number": "931-484-9511",
            "fax_number": "931-456-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLISON",
        "first_name": "MICHAEL",
        "middle_name": "GARY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-09",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "PA",
            "license": "OS-006810L",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MS",
            "license": "18895",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NY",
            "license": "188099",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OH",
            "license": "6347",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TN",
            "license": "1974",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "188099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01715897",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016134270002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

Verify at the official NPI Registry.