Tracy L. Allen, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

005894 Issued in GA

Practice address

101 Riverstone Vis
Suite 111
Blue Ridge, GA 30513-6648

Phone

(706) 946-4200

Fax

(706) 946-4243

NPI assigned

Aug 3, 2006

Last updated

Jun 21, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Georgia Cancer Specialists I, PC

  • Specialist
  • Atlanta, GA
  • NPI 1821076241
  NPD (past)
• NSH Cancer Institute Professional Services G, LLC

  • Hematology & Oncology Physician
  • Atlanta, GA
  • NPI 1124379284
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403308800000",
    "number": "1124036520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RIVERSTONE VIS",
            "address_2": "SUITE 111",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305136648",
            "telephone_number": "706-946-4200",
            "fax_number": "706-946-4243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 RIVERSTONE VIS",
            "address_2": "SUITE 111",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305136648",
            "telephone_number": "706-946-4200",
            "fax_number": "706-946-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "TRACY",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2014-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA-440",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "005894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003100897C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vincent John Acunto, RN, FNP-C
• Adventa Hospice, Inc. (Amedisys Hospice of Blue Ridge)
• Amedisys Northwest LLC (Amedisys Northwest Home Health)
• Harriette Angi Arscott
• Umer Ashraf, RPH
• Assist Healthcare Services, Inc. (Assist Healthcare Staffing)
• Kenney Scott Atkins, M.D.

• Medical Physician Assistant in Blue Ridge, GA
• Providers in Blue Ridge, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2014; 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.