Individual provider Active NPI

John J. Allan, M.D.

  • Cardiovascular Disease Physician
  • Statesville, NC
National Provider Identifier
1235121997
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
9701683 Issued in NC
Practice address
1424 Fern Creek Dr
Suite D
Statesville, NC 28625-9376
Phone
(704) 878-2058
Fax
(704) 872-6576
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 9701683 NC Primary

Addresses

Primary practice location

1424 Fern Creek Dr
Suite D
Statesville, NC 28625-9376

Mailing address

1424 Fern Creek Dr
Suite D
Statesville, NC 28625-9376
Phone (704) 878-2058

Other identifiers 1

IdentifierTypeStateIssuer
891101VMedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address john.allan.1@4693.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041101000584 NC Practitioner - Cardiovascular Disease (Cardiology) 5193787273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Kansas School of Med (KC/Wich/Sal), 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iredell Physician Network LLC 91 clinicians

Practice addresses (Care Compare)

925 Thomas St
Statesville, NC 28677-3484
Phone (704) 883-3378

Hospital & facility affiliations

  • Iredell Memorial Hospital Inc Hospital, Statesville, NC, CCN 340039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Iredell Physician Network LLC CurrentSince Jun 1, 2021 Accepting new patients
Iredell Physician Network LLC Current Accepting new patients
Iredell Physician Network LLC CurrentSince Jun 1, 2021 Accepting new patients
Iredell Physician Network LLC Past Accepting new patients

Locations

653 Bluefield Rd
Ste F
Mooresville, NC 28117
Phone (704) 360-6480

653 Bluefield Rd
Ste D
Mooresville, NC 28117
Phone (704) 360-6470

1410 Fern Creek Dr
Statesville, NC 28625
Phone (704) 873-6863

766 Hartness Rd
Statesville, NC 28677
Phone (704) 838-2182

925 Thomas St
Statesville, NC 28677
Phone (704) 873-0263

Interoperability endpoints

  • Direct secure messaging: john.allan@iredell.cernerdirect.com
  • Direct secure messaging: john.allan.1@4693.direct.athenahealth.com

Organizations & group practices 8

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1235121997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 FERN CREEK DR",
            "address_2": "SUITE D",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286259376",
            "telephone_number": "704-878-2058",
            "fax_number": "704-872-6576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 FERN CREEK DR",
            "address_2": "SUITE D",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286259376",
            "telephone_number": "704-878-2058",
            "fax_number": "704-872-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLAN",
        "first_name": "JOHN",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "9701683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891101V",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "john.allan.1@4693.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct access",
            "address_1": "1424 Fern Creek Dr",
            "address_2": "Suite D",
            "city": "Statesville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "286259376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.