Jimmie Dean Allen, ED.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2001006337 Issued in MO

Practice address

3505 Frederick Ave
Saint Joseph, MO 64506-2914

Phone

(816) 387-2615

Fax

(816) 387-2390

NPI assigned

Mar 23, 2007

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174640544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 FREDEREICK AVE",
            "city": "ST. JOSEPH",
            "state": "MO",
            "postal_code": "64506",
            "telephone_number": "816-387-2615",
            "fax_number": "816-387-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 FREDERICK AVE",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062914",
            "telephone_number": "816-387-2615",
            "fax_number": "816-387-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "JIMMIE",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "ED.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2001006337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Saint Joseph, MO
• Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.