Organization Active NPI

Allen Spine and Sports Medicine, PC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Wilmington, NC
National Provider Identifier
1174960124
Registry record updated May 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
Legal business name
ALLEN SPINE AND SPORTS MEDICINE, PC
Practice address
1721 Allens LN Ste 101
Wilmington, NC 28403-3662
Phone
(910) 515-1506
NPI assigned
May 31, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2013

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

Authorized official

Name
Joanne Bell Allen, MDNPI 1619901030
Title
Physician Owner
Phone
(910) 515-1506

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081S0010X Primary

Addresses

Primary practice location

1721 Allens LN Ste 101
Wilmington, NC 28403-3662

Mailing address

PO Box 1568
Wrightsville Beach, NC 28480-1568
Phone (910) 515-1506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140402000050 NC Part B Supplier - Clinic/Group Practice 2961633151 Receives reassigned benefits from 1 practitioner
Practice locations: Wilmington, NC

National Provider Directory

National Provider Directory

Locations

2030 Eastwood Rd
Ste 8
Wilmington, NC 28403
Phone (910) 515-1505

1721 Allens Ln
Ste 101
Wilmington, NC 28403
Phone (910) 256-4442

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369958400000",
    "number": "1174960124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1568",
            "city": "WRIGHTSVILLE BEACH",
            "state": "NC",
            "postal_code": "284801568",
            "telephone_number": "910-515-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 ALLENS LN STE 101",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284033662",
            "telephone_number": "910-515-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEN SPINE AND SPORTS MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-31",
        "last_updated": "2013-05-31",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "BELL",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "910-515-1506",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.