Marlin Calvin Allen
Individual provider Active NPI Family Nurse Practitioner · Dalton, GA
NPI 1245847367 · NPPES record last updated Sep 24, 2020
Key facts
- NPI
- 1245847367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN237743 (GA)
- Practice address
- 1209 W Walnut Ave Ste 1
Dalton, GA 30720-3961 - Phone
- (706) 459-3572
- NPI assigned
- Sep 24, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Utm of Georgia Physicians LLC
Practice addresses (Care Compare)
1209 W Walnut Ave
Suite 1
Dalton, GA 30720-3961
Phone (706) 459-3572
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201009000183 | GA | Practitioner - Nurse Practitioner | 5890115034 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN237743 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Utm of Georgia Physicians LLC | Current |
Accepting new patients |
Locations
1209 W Walnut Ave
Ste 1
Dalton, GA 30720
Phone (706) 226-2200
400 Battlefield Pkwy
Ft Oglethorpe, GA 30742
Phone (706) 944-9018
30 Burton Hills Blvd
Ste 175
Nashville, TN 37215
Phone (615) 988-2014
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN237743 | GA | Yes |
Addresses
Primary practice location
1209 W Walnut Ave Ste 1
Dalton, GA 30720-3961
Mailing address
149 Joyce Dr
Ringgold, GA 30736-2707
Phone (478) 697-1725
Other providers in Dalton, GA
- All Family Care LLC
- All-in Counseling & Telementalhealth, LLC
- Jennifer Lee Allen
- John Allen
- Karen M. Allen
- Patricia A Allen
- Claire Allman
- Alpha Wellness Center Inc.
- Majd Mohammad Alrawashdeh
- Maya Alsadi
All providers in Dalton, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.