Michelle Harper Allen, M.D.
Individual provider Active NPI Pediatrics Physician · Atlanta, GA
NPI 1255697256 · NPPES record last updated Feb 8, 2019
Key facts
- NPI
- 1255697256
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 74255 (GA)
- Practice address
- 3896 Princeton Lakes Way
Atlanta, GA 30331 - Phone
- (404) 489-4444
- NPI assigned
- Apr 4, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
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: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170503001575 | GA | Practitioner - Pediatric Medicine | 2062799828 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74255 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grady Memorial Hospital Corporation | Pediatrics | Current |
Accepting new patients |
| Grady Memorial Hospital Corporation | Current |
Accepting new patients | |
| Grady Memorial Hospital Corporation | Current |
Accepting new patients | |
| Premier Pediatrics Associates | Pediatrics | Past | Accepting new patients |
Locations
80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370
3896 Princeton Lakes Way SW
Atlanta, GA 30331
Phone (404) 489-4444
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 74255 | GA | Yes |
Addresses
Primary practice location
3896 Princeton Lakes Way
Atlanta, GA 30331
Mailing address
3896 Princeton Lakes Way
Atlanta, GA 30331
Phone (404) 489-4444
Other practice location 1
3200 Highlands Pkwy SE
Suite 118
Smyrna, GA 30082-5166
Phone (404) 220-7660
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003162730 | Medicaid | GA |
Other names
- Michelle Kenya Harper
Other providers in Atlanta, GA
- Lori Hackett Allen
- Marian Allen
- Mary Coleman Allen
- Mary Watson Allen
- Melissa Allen
- Miranda Allen
- Nelson Allen
- Pamela B Allen
- Ramar Radcliffe Allen
- Raymond J. Allen
All providers in Atlanta, GA · Pediatrics Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2019. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.