Individual provider Active NPI

Brian James Allen, PA

  • Physician Assistant
  • Grants Pass, OR
National Provider Identifier
1124298617
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01343 Issued in OR
Practice address
702 SW Ramsey Ave Ste 112
Grants Pass, OR 97527-5859
Phone
(541) 472-0603
Fax
(541) 472-0609
NPI assigned
Mar 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01343 OR Primary

Addresses

Primary practice location

702 SW Ramsey Ave Ste 112
Grants Pass, OR 97527-5859

Mailing address

2780 E Barnett Rd Ste 200
Medford, OR 97504-8674
Phone (541) 779-6250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20080327000442 OR Practitioner - Physician Assistant 7113003336 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA01343ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Oregon Orthopedics Inc Physician Assistant CurrentSince Sep 3, 2019 Accepting new patients

Locations

702 SW Ramsey Ave
Ste 112
Grants Pass, OR 97527
Phone (541) 472-0603

1780 Nebraska Ave
Grants Pass, OR 97527
Phone (541) 472-0603

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

2780 E Barnett Rd
Ste 200
Medford, OR 97504
Phone (541) 779-6250

Organizations & group practices 3

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 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Oregon Orthopedics Inc 64 clinicians

Practice addresses (Care Compare)

2780 E Barnett Rd
Suite 200
Medford, OR 97504-8674
Phone (541) 779-6250

Hospital & facility affiliations

  • Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002
  • Curry General Hospital Hospital, Gold Beach, OR, CCN 381322

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1124298617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 E BARNETT RD STE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048674",
            "telephone_number": "541-779-6250",
            "fax_number": "541-608-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 SW RAMSEY AVE STE 112",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275859",
            "telephone_number": "541-472-0603",
            "fax_number": "541-472-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "BRIAN",
        "middle_name": "JAMES",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-11",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

Verify at the official NPI Registry.