Active NPI
Kyle Allred, PA-C
- Physician Assistant
- Eureka, CA
National Provider Identifier
1124372230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA22625
- Practice address
- 2412 Buhne St
Eureka, CA 95501-3207 - Phone
- (707) 826-8633
- NPI assigned
- Oct 29, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA22625 | CA | Primary |
Addresses
Primary practice location
2412 Buhne St
Eureka, CA 95501-3207
Mailing address
670 9TH St
Suite 203
Arcata, CA 95521-6248
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351555200000",
"number": "1124372230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "670 9TH ST",
"address_2": "SUITE 203",
"city": "ARCATA",
"state": "CA",
"postal_code": "955216248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2412 BUHNE ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955013207",
"telephone_number": "707-826-8633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLRED",
"first_name": "KYLE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-29",
"last_updated": "2012-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA22625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.