Active NPI
Amanda Kate Allen, MD
- Psychiatry Physician
- Charleston, SC
National Provider Identifier
1235798299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- LL82817
- Practice address
- 861 MSC
Charleston, SC 29425-1009 - Phone
- (843) 792-9162
- Fax
- (843) 792-9163
- NPI assigned
- Jun 12, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | LL82817 | SC | Primary |
Addresses
Primary practice location
861 MSC
Charleston, SC 29425-1009
Mailing address
169 Ashley Ave RM 202
Charleston, SC 29425-8905
Phone (843) 792-9162
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LL82817 | Other | SC | LIMITED MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL82817 | SC | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560297600000",
"number": "1235798299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "169 ASHLEY AVE RM 202",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294258905",
"telephone_number": "843-792-9162",
"fax_number": "843-792-9163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "861 MSC",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294251009",
"telephone_number": "843-792-9162",
"fax_number": "843-792-9163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "AMANDA",
"middle_name": "KATE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-12",
"last_updated": "2019-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "SC",
"license": "LL82817",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIMITED MEDICAL LICENSE",
"identifier": "LL82817",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.