Individual provider Active NPI

Marchelle Isyk Allen, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1235230673
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-00586 Issued in NC
Practice address
15235 John J Delaney Dr Ste B
Charlotte, NC 28277-2846
Phone
(704) 243-8937
Fax
(704) 243-8926
NPI assigned
Sep 26, 2006
Last updated
May 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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 0010-00586 NC Primary

Addresses

Primary practice location

15235 John J Delaney Dr Ste B
Charlotte, NC 28277-2846

Mailing address

4601 Park Rd Ste 300
Charlotte, NC 28209-2290
Phone (704) 323-2000

Other practice location 1

2001 Vail Ave
Suite 200
Charlotte, NC 28207-1219
Phone (704) 323-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MALLEN746491@DIRECT.NOVANTHEALTH.ORG

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070130000656 NC Practitioner - Physician Assistant 0244231470 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Brody School of Medicine at East Carolina University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

11840 Southmore Dr
Suite 100
Charlotte, NC 28277-4821
Phone (704) 384-7976

15235 John J Delaney Dr
Suite B
Charlotte, NC 28277-2846
Phone (704) 243-8937

1530 S Providence Rd
Waxhaw, NC 28173-8313
Phone (704) 627-8365

600 Highland Oaks Dr
Winston Salem, NC 27103-7107
Phone (366) 774-0040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-00586NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Medicorp Enterprises, LLC CurrentSince Aug 5, 2019 Accepting new patients
Carolina Medicorp Enterprises, LLC CurrentSince Aug 5, 2019 Accepting new patients
Emergency Medicine Physicians of Iredell County, PLLC Past Accepting new patients
Carolina Medicorp Enterprises Inc Past Accepting new patients

Locations

15235 John J Delaney Dr
Ste B
Charlotte, NC 28277
Phone (704) 243-8937

9550 Rocky River Rd
Ste 150
Charlotte, NC 28215
Phone (704) 457-1510

600 Highland Oaks Dr
Winston Salem, NC 27103
Phone (366) 774-0040

Interoperability endpoints

  • Direct secure messaging: mallen746491@direct.novanthealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1235230673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092290",
            "telephone_number": "704-323-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15235 JOHN J DELANEY DR STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282772846",
            "telephone_number": "704-243-8937",
            "fax_number": "704-243-8926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Vail Ave",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282071219",
            "country_code": "US",
            "telephone_number": "704-323-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "MARCHELLE",
        "middle_name": "ISYK",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-00586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MALLEN746491@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "15235 John J Delaney Dr Ste B",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282772846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.